IshratKhurshid
Guest
Can someone please answer this question?
Humana is paying 78% of the Medicare allowable on a J code. We are already billing the patient the difference between Humana allowable and what Humana paid. Do we have also need to bill the patient the difference between Humana allowable and Medicare Allowable?
Here is an example;
Humana:
Allowed-------Paid-------Patient Resp.
$862.70-------$680.33-------$182.37
Medicare:
Allowed-------Paid-------Patient Resp.
$999.46-------$799.57-------$199.89
We billed the patient $182.37. Do we need to bill the patient $199.89 instead?
Thanks!
Humana is paying 78% of the Medicare allowable on a J code. We are already billing the patient the difference between Humana allowable and what Humana paid. Do we have also need to bill the patient the difference between Humana allowable and Medicare Allowable?
Here is an example;
Humana:
Allowed-------Paid-------Patient Resp.
$862.70-------$680.33-------$182.37
Medicare:
Allowed-------Paid-------Patient Resp.
$999.46-------$799.57-------$199.89
We billed the patient $182.37. Do we need to bill the patient $199.89 instead?
Thanks!