I have a patient that was clearly injured in an auto accident last October 2011. I just started working here last month. The patient has been seen here since Nov 2011. He has auto insurance that is in litigation. The company has been filing through his primary insurance (which sent a letter of denial) and now filing through Medicaid with the primary letter of denial. They have never billed the auto insurance or have any information in his file on the auto insurance. I printed the HICFA today and it said "No" for auto related. When I questioned them about this, they said that the auto in in litigation and may take years to settle. Once settled, they will pay back Medicaid. My response was, not if there aren't any claims on file.
From my experience, I was taught to file auto, then primary, then secondary. Also, I feel it should be marked "Yes" for auto related.
Which way is correct?
Also, if I'm correct, could this company be in jeopardy for possible fraud for marking "No" and not billing auto?
Please advise. Thank You.
From my experience, I was taught to file auto, then primary, then secondary. Also, I feel it should be marked "Yes" for auto related.
Which way is correct?
Also, if I'm correct, could this company be in jeopardy for possible fraud for marking "No" and not billing auto?
Please advise. Thank You.