Wiki Billing Patient Non Covered Services

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codernickie

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Do we have to have patients sign a non covered service form for procedures that are billable to their insurance but may not be covered under their benefit plan? If we do have to bill patients once it has been denied by their insurance does it has to be the insurance contracted rate or self pay rate?

Thanks
Nickie B, CPC
 
The EOB will tell the provider what the patient responsible portion is that is what you must charge the patient. Some commercials may required a signed statement but generally anything you know is non covered does not need a waiver.
 
Hi Debra,
Usually, when the insurance denies a claim there is no allowed amount to bill the patient the insurance will adjust the entire billed amount. Only when it is applied to their deductible there is allowed amount. So I am not sure if I am billing the patient for our contracted rate for that particular insurance or self pay rate

Thanks
 
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