Results 1 to 2 of 2

Self Pay to Insurance

  1. #1
    Question Self Pay to Insurance
    Medical Coding Books
    If a patient self pays for a procedure, but then later requests that it be submitted to their insurance, are we obligated to submit it to insurance? The doctor had the patient self-pay because he thought there was no medical nec. In addition, we did didnt complete any type of pre-determination, and its past timely filing.

  2. #2
    Smile
    No, you are not obligated. However, I do require my patients to fill out the cash patient waiver form which spells out that we will not bill insurance and they have the option to have this portion of their visit blinded from 3rd party requests.

    I would recommend having a form to protect you in the event. Also, you might want to check with your provider agreement. Some plans REQUIRE you to bill the insurance. If you have the form in place, you can cover yourself/practice from any violations the payor may impose.
    [COLOR="Blue"]Kandy Morris CCS, CCS-P, CPC, CPB, CPC-I, CPMA, CEMC, CPOC
    AHIMA-approved ICD-10CM/PCS Trainer & Ambassador
    AAPC PMCC Approved Instructor
    Email: kandymorris3@yahoo.com

Similar Threads

  1. Self Pay, when you take their insurance
    By codernickie in forum Billing/Reimbursement
    Replies: 12
    Last Post: 08-27-2015, 01:47 PM
  2. insurance vs self pay
    By kidral97 in forum Compliance General Discussion
    Replies: 2
    Last Post: 05-15-2015, 09:36 AM
  3. Insurance vs Self-pay
    By chavera in forum Billing/Reimbursement
    Replies: 2
    Last Post: 05-31-2013, 10:25 AM
  4. Insurance to Self Pay
    By amym in forum Billing/Reimbursement
    Replies: 5
    Last Post: 07-18-2011, 02:21 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.