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Thread: Medicare benefit max denials...

  1. #1
    Join Date
    Apr 2007
    Albany, NY

    Default Medicare benefit max denials...

    AAPC: Back to School
    If Medicare denials a service with a bene max denial and does not hold the pt responsible for the visit BUT at time of the visit a pt signs a general treatment waiver stating that if their insurance co does not pay for or cover visit then they are responsible for balance of visit, can I bill the pt for the visit?

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    ABNs cannot be general they must be specific for the procedure or service to be waived and include the diagnosis as well as the amout expected to be charged. If ypu did not have this done and then use the GA modifier on the line item then no you cannot bill the patient, as the patient has received the EOB telling them they do not owe the provider.

    Debra A. Mitchell, MSPH, CPC-H

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