Wiki Billing Auto Insurance vs Private Insurance

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kathymoon

kathymoon

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I have a couple of doctors (one in particular) that see patients for their MVA and then at the same visit decides to remove a lesion or two, of course, not related to the MVA. Does anyone know if I can bill the Auto insurance for the injuries from the accident and bill the private insurance for the lesion removal. I was told long ago that this was not possible but I thought I saw or heard somewhere that this was acceptable. Any ideas would be greatly appreciated.:confused:
 
It is acceptable to bill the auto ins for the injuries/conditions related directly to the MVA and the personal insurance for the procedure that was unrelated. This does however require two separate notes to be created, each note needs to be able to stand alone. This is the same with Workers Comp. We have advised our patients that if they come in for a WC visit and have an related problem they'd like to discuss then they must pay their co-pay or co-insurance before they leave the office.
 
Retired medical biller (20+ years)

I agree with reply from SStauring. I am wondering what type of medical insurance the patient has? This info would help to predict the outcome of payment or denial based on the policy/contract. You need two separate and complete medical notes and two separate medical bills/invoices. It is important to keep the lesion charges away from billing to the auto policy because it is not correct to bill that carrier for unrelated services. If it gets billed and paid in error, you would need to refund the auto carrier no matter the size of the payment. This leads to a lot of work where I was employed.

June Grimmette CPC-A
Retired from Michigan Medicine (U of M Health System)
 
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