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Thread: Insurance change mid-OB global??

  1. #1
    Join Date
    Apr 2007
    St Joseph

    Question Insurance change mid-OB global??

    AAPC: Back to School
    We have a patient whose insurance(employer)changed compaines and she had already had 8 visits before 12/31 and after she had 10 visits and then delivery, All with the same physician. Can we bill the first 8 visits with her previous insurance or do we bill global with all 18 visits and delivery with her current insurance? Also do you bill antepartum visits (if no delivery)on the last day the patient saw the physician in the clinic or on date of delivery if they are different? We are in a dilemma. Thanks
    Last edited by LLinville; 04-17-2009 at 09:14 AM. Reason: clarification

  2. #2
    Join Date
    Apr 2007
    Kansas City, MO


    When the employer switches insurance plans, normally their is something built into the policy regarding this issue. We normally contact the insurance to verify the patients policy and if we are to file the global to them or perform a bill out with the previous insurance.

    As for the bill out date on the antepartum we use the last date the patient was seen under the old insurance to bill those antepartum visits. As for the current insurance our offices normally use the last date the patient was seen before the delivery.

    Hope this helps,
    Angela Jordan, CPC
    AAPC of Kansas City
    National Advisory Board Representative Region 5

    Medical Revenue $olutions
    Senior Managing Consultant


  3. #3
    Join Date
    Apr 2007
    Cedar Rapids, Iowa


    I actually called several of my insurance representatives on this issue and made a general inquiry, but the answers were unanimous. The "rule" is bill each company for the specific service provided during the period of each coverage.

    However when it is the SAME employer - only the insurance has changed - usually I would call the new insurance policy and verify how they would then prefer the global billing be charged to them. In most cases I've found that they prefer to have the services that occurred during the effective dates of the old insurance to the old insurer and those services that occurred under the new insurance to the new insurer.

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