Wiki Balances

[ldiaz12687]

Are you allowed to bill a patient for a balance for a service that wasn't covered by their insurance? For example, you bill 99204 to their insurance, and it comes back as denied, can you send a invoice to the pt for that amount that was denied?

 

[cgaston]

It would depend on the reason for the denial.

 

[ldiaz12687]

It would depend on the reason for the denial.

If it came back as a service not covered under their insurance plan. Like an exclusion. Is that amount the patients responsibility or does the office write it off?

 

[cgaston]

If you had the patient sign a waiver stating they realize they will be responsible for payment of the service since it is not covered under their plan you can bill them. If you did not check to see if it would be covered before you provided the service you will have to write it off.