Wiki Billing codes that are non-covered

[apink]

Question...

I think I know the answer to this, but I would like to confirm for someone else in the office.

If a patient comes into the office (specialist) and has a procedure done that is normally non-covered by insurance, is it still correct billing to send to the patient's insurance and get a denial for the procedure or just bill the patient since it is knowingly non-covered?

Would love if someone could give me a heads up to this, so that we are billing it accordingly.

Thanks,
Amy

 

[EricLam88]

It depends on your office policy.

If you are 100% sure that the procedure is not covered, then you should inform patient that the procedure is not covered by their policy and that they have to pay for out of pocket.

You guys can also bill the insurance company and get a denial notice, but that would delay payment for the services.

 

[apink]

Thanks Eric.

That's what we have been doing, I only wanted to double-check.