I was just thrown for a loop today and wanted to see if I have been living in the dark or is the organization I am with have a chance to collect a bunch of money they have been writing off.
When you are non participating with a commercial carrier you are not required to write off anything, is this correct? My understanding was you can submit a claim to insurance for the patient but you still get paid your full amount be it from a combo of the insurance and patient paying or just the patient if insurance never comes thru for whatever reason.
I just found out today that if you are non par with Aetna they have a 90 day filing limit. If we aren't getting are claims in during this time frame (ie the insurance shows no record of the claim doesn't mean we didn't send it), they (our billing department) is writing them off. This blew me away. Am I wrong? I was told that we have to follow the insurance bylaws and regulations. I have never heard of this before. If this is the case does someone have the link for them? I can't find anything. I am in Michigan.
I don't normally have any involvement in the back end collection process where I work now so I had no idea this was going on.
Thanks
Laura, CPC, CEMC
When you are non participating with a commercial carrier you are not required to write off anything, is this correct? My understanding was you can submit a claim to insurance for the patient but you still get paid your full amount be it from a combo of the insurance and patient paying or just the patient if insurance never comes thru for whatever reason.
I just found out today that if you are non par with Aetna they have a 90 day filing limit. If we aren't getting are claims in during this time frame (ie the insurance shows no record of the claim doesn't mean we didn't send it), they (our billing department) is writing them off. This blew me away. Am I wrong? I was told that we have to follow the insurance bylaws and regulations. I have never heard of this before. If this is the case does someone have the link for them? I can't find anything. I am in Michigan.
I don't normally have any involvement in the back end collection process where I work now so I had no idea this was going on.
Thanks
Laura, CPC, CEMC