Wiki Billing pt to make up for cost of vaccine

[dorothysalyer@yahoo.com]

Hi
A pt comes in for well child visit and vaccines. The insurance says it is covered 100%. However we do not get paid from ins. co to cover the cost of some of our vaccines. Can our office charge the pt for remaining balance?

 

[MarcusM]

You should appeal to the insurance company. What vaccine are they not covering??? When varicella first came out, BCBS paid me $10.00 for the vaccine. I appealed with the vaccine invoice, and they came back and paid the full cost plus a percentage above. They usually pay AWP plus a percentage. If you are not buying in bulk, that may be the issue.

 

[mitchellde]

Hi
A pt comes in for well child visit and vaccines. The insurance says it is covered 100%. However we do not get paid from ins. co to cover the cost of some of our vaccines. Can our office charge the pt for remaining balance?

No you may not bill the patient any part of something the payer states they cover 100%