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Insurance change mid-OB global??

  1. #1
    Location
    St Joseph
    Posts
    15
    Question Insurance change mid-OB global??
    Medical Coding Books
    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 10:14 AM. Reason: clarification

  2. #2
    Location
    Kansas City, MO
    Posts
    751
    Default
    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, COBGC, AAPC Fellow
    Senior Managing Consultant
    Medical Revenue Solutions, LLC
    AAPC National Advisory Board - Southwest
    AAPCCA BOD Chair 2012-2013
    angela@medicalrevenuesolutions.com

  3. #3
    Location
    Cedar Rapids, Iowa
    Posts
    6
    Default
    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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