Wiki Guidelines for billing attorneys

[belinda@bcbilling.com]

We have a client that has a patient with no insurance on file. It is an attorney litigation case. In deposition I was asked if we sent the claim form or HCFA1500 to the attorney as mandated by AMA guidelines. I have researched the guidelines with other sources and I do not see anywhere where it sates that a patient and/or their attorney needs to be given a a HCFA1500 form in order the the litigation case to be paid. Can someone confirm this with me?

 

[thomas7331]

I have never heard such a thing and it sounds to me like they were bluffing or trying to intimidate you, which I've heard is common at depositions. For one thing, the AMA can't 'mandate' anything - it is not a governmental agency and does not have that power - and 'guidelines' are just that, they are neither laws nor regulations. As lawyers and patients are not insurance companies and are not HIPAA covered entities, I can't imagine there would be any law that would require a healthcare provider to send them a 1500 form. In fact, unless you received a HIPAA release from the patient instructing you to do so, it likely could have been a violation to send one. If they needed one, or any other particular piece of information for that matter, they would have, and could have asked for it. To be honest, I would take their question with a grain of salt.

 

[belinda@bcbilling.com]

Thank you so much. That is exactly what I thought. I have never heard such a thing. I consulted with outside legal and they also never heard of this or any other regulation or law stating a HCFA 1500 form would need to be sent to an attorney or patient as opposed to just sending a statement or billing ledger.