MonarchMedBill
Guest
Hi guys!
I work in a physician network for a set of physicians. One of our physicians did a bariatric consult. He did not sign/lock the progress notes until 117 days after the DOS. The insurance is UHC and our contract states timely filing is 95 days. In our office, this tends to happen often and the protocol is to submit the claim anyway to get the timely filing denial for the patient file. Now that we have the denial back I need to adjust off the balance. However, here is my question:
The patient paid $60.00 on the DOS. The claim billed amount is $620.00 and the balance currently sits at $560.00. I've never come across a patient balance in this situation. Are we under an obligation to refund the patient and adjust off the $620.00 billed amount? Or do we accept the $60.00 as paid in full and adjust off the $560.00 balance?
Thanks in advance!
I work in a physician network for a set of physicians. One of our physicians did a bariatric consult. He did not sign/lock the progress notes until 117 days after the DOS. The insurance is UHC and our contract states timely filing is 95 days. In our office, this tends to happen often and the protocol is to submit the claim anyway to get the timely filing denial for the patient file. Now that we have the denial back I need to adjust off the balance. However, here is my question:
The patient paid $60.00 on the DOS. The claim billed amount is $620.00 and the balance currently sits at $560.00. I've never come across a patient balance in this situation. Are we under an obligation to refund the patient and adjust off the $620.00 billed amount? Or do we accept the $60.00 as paid in full and adjust off the $560.00 balance?
Thanks in advance!