Wiki Compliance for checking active insurance

[tobalx]

Can clinics check if a client has active Medicaid even though the client stated at check in they do not have any insurance? If it is active, can we bill the insurance even though the client stated they don't have insurance & we did not advise them we are going to bill their insurance since it was after services were rendered that active coverage was found.

 

[CBLENNIE]

Are you contracted with the active insurance plan? If so, your provider contract probably indicates that you are required to bill insurance, especially if is Medicare or Medicaid. You might consider reaching out to the patient to discuss the issue. You don't want to get in trouble with the payer if you are contracted or participating but you also don't want to cause any patient abrasion by billing the insurance plan without their knowledge.