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  1. #1
    St.Louis East Chapter
    Question Billing
    Medical Coding Books
    If a patient has insurance are they able to be self pay. Is there a rule to say that we must bill insurance if they have it. If we know the patient will have to pay more out of pocket with the insurance. Is it okay to implement self pay.

  2. #2
    If you are contracted with their insurance your contract states that you would have to bill the insurance company. and that you must bill the patient for their co-pays and deductible according to the EOB. Ask you insurance contract person they should be able to show this to you in their contract.

    Hope this helps.
    Debbie Potts England
    Lyles, TN 37098

  3. #3
    Lafayette, LA
    A patient who wants to be self pay - wether they have ins. or not - can be self pay. The contract between physicians and ins. co's. is mostly for contracted rates. If the patient does not want thier ins. billed then they can be self pay.

  4. #4
    St.Louis East Chapter
    Default Billing
    Thanks for the help. It looks like the office I work for have a self pay plan that the patient will pay one set price if they know the out of pocket is too much for the patient. We are suppose to just charge the patient 20 dollars for physical therapy. I guess this is just some form of way of not turning anyone way if we are out of network with their insurance.

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