Wiki Secondary Insurance questions

[Rbanskikum]

Location: CA
Behavioral Health - Autism

The company I worked for was bought out in 2022. I used to be the only one in our billing department. Now I work under someone that doesn't have a CPC or CPB. The person has been with the company for many years and was handling everything. Now that I'm on board things have been going more smoothly but at the same time I'm finding issues. Our latest issue is that she informed me certain clients had secondary insurance(medi-cal) and that they have been billed out. I have done an audit of outstanding secondary claims and noticed that they were never sent to a secondary and found out these clients do not have secondary insurance. Some of these claims are more than a year old. I want to make sure I can still bill the families for copays. Most of these families are low-income families and might not be able to pay these invoices. What is the best practice to say to these clients and put them on a payment plan?

Thanks for the help

 

[csperoni]

Unless it's over the timeframe your state allows for medical debt (in NY it's 3 years), I would certainly bill the patient/guarantor for any copay/co-insurance/deductible they are responsible for. If you think it would be helpful, you could add a sentence or two to their bills. I would not get into the details of exactly why you are billing a year later. Maybe something like:
This balance is for your responsibility after processing by your insurance company. Please contact us at ###-###-#### or email@email.com if you would like to arrange for a payment plan.
If your company does not already have one, you may want to consider a financial hardship policy (but that's a business decision).