Wiki Denial code PI 204

Tgarner2016

Contributor
Local Chapter Officer
Messages
15
Location
Sevierville, TN
Best answers
0
I have received Remit Data for a patient showing denial code PI 204. Service not covered by current benefit plan. This is from AARP Supplemental Plan. In the Patient Resp section it does not show a patient resp but it is completely blank. I am 90% certain this can be billed to the patient. Possibly this supplement plan does not cover for the deductible from Medicare. Am I correct? My office manager seems to think we just write this off. Any advice would be appreciated. Thank you
 
I would agree with you, the Medicare supplement plans such as AARP generally do not require providers to write off additional amounts over and above the Medicare allowance, they just either pay the balance or leave it to patient share. Of course the only way to know for sure is to contact them and get an explanation for the missing information.
 
I have received Remit Data for a patient showing denial code PI 204. Service not covered by current benefit plan. This is from AARP Supplemental Plan. In the Patient Resp section it does not show a patient resp but it is completely blank. I am 90% certain this can be billed to the patient. Possibly this supplement plan does not cover for the deductible from Medicare. Am I correct? My office manager seems to think we just write this off. Any advice would be appreciated. Thank you
Yes, you can bill this to the patient. You are getting that reason code because the patient has a supplemental plan that does not cover the medicare deductible.
 
Top