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Hi,

We have a few claims who denied payment because of reason code CO-96 (Non covered charges ) from Primary as well as Secondary insurance. Can we bill this to patient?

Please advise.

Jay
 

mitchellde

True Blue
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Location
Columbia, MO
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This will depend on the payer. If it is Medicare you must have obtained an ABN prior to the procedure and used a GA modifier when the claim was originally submitted. Other payers may require some similar form of a waiver prior to the procedure. If the EOB indicates do not bill patient then of course you cannot.
 
Messages
6
Best answers
0
This will depend on the payer. If it is Medicare you must have obtained an ABN prior to the procedure and used a GA modifier when the claim was originally submitted. Other payers may require some similar form of a waiver prior to the procedure. If the EOB indicates do not bill patient then of course you cannot.
Thank you.
 
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