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Patient Billing

  1. Default Patient Billing
    Medical Coding Books

    My boss asked me to send out patient statements that are 2-3yrs old and wanted to know what is the actual time limit for patients statement to be mailed out.

    Thank You

  2. Default
    I don't know if there really is a time limit on bills but I can tell you what I do when I mail out older statements. I attach a letter that explains 'during an internal audit of outstanding accounts, we have come across some dates of service that remain unpaid on your account". You can then go on a explain in more detail if you prefer. You will get people that will refuse and others will complain about the length of time.

  3. Default
    You might want to check with your state guidelines, different states have different guidelines. I can tell you though, that if I received a bill for something 2-3 years old and have never been billed for it before, I would not pay it personally. I don't think it is very professional or ethical to bill a patient for a 3 year old service that they have never been billed for before. If the provider didnt sound out bills for 2-3 years that is his fault, not the patients. If the accounting is that poor than how would a patient be able to dispute the bill? You are past timely filing for insurance and the patient might say that they paid copays/coinsurance and you didnt have it recorded.

  4. Default
    I agree with ReginaR, check your state guidelines as I am sure that they differ from state to state. However, I would consider the cost of sending these statements as well as the cost of time taking calls to explain the situation compared to the amount of payment you expect to receive (which will be very little) to see if the bottom line is even worth it.

    Penguins11- How long does an insurance company have to recoup money on a payment made to a provider? Sometimes patient statements are necessary to be sent after a long period of time, when fault is not of the provider's. Example: Patient is seen and pays required copay, insurance company pays/adjusts remainder of bill. Later, insurance company determines that patient's coverage was inactive at the time of service. Insurance sends a corrected EOB and recoups previous payment. This balance is now the patient's responsibility.
    While I will agree that this is probably not the situation that Ania773 is referring to, it is possible and happens quite frequently.
    Tracey Thompson, CPC, CPPM

  5. #5
    Lauderdale Lakes
    I have sent bills out to patients that have been about a year old. No fault of ours. Insurance denied and I had to appeal and appeal. May take a year or so to get insurance to pay. Then I send bill to the patient for their portion. I have gotten angry calls from patients telling me I have no right to bill them after a year. I told them I could have sent them a bill earlier for the full amount but I was trying for a year to get their insurance to pay so they would not have a high bill. Some patients dont understand. I tell them they are responsible or they go to collections. But this is a case where I have been trying to get an insurance to pay. I have never had one where we just forgot to bill a patient. I live in the Florida and insurance companies are able to recoup money 2 1/2 years previous. I then bill the patient. I dont know of any time limits.

  6. Default
    I am not talking about situations in which it takes forever for the insurance company to pay and then you have to bill the patient because their insurance company took so long. I highly doubt though that the original question was because the patient wasnt billed because the insurance company took 2-3 years to pay. It sounds like from the original question, the dr just didnt send statements for some reason, my response was based on this scenario. Also, we negotiate into our commercial contracts time limits that insurance companies are allowed to take money back. Most of our contracts we say 2 years. I still don't think it is right to send statements to patients that are 2-3 years old if it is your fault you didnt bill.

  7. #7
    Tacoma, WA
    There are a lot of scenarios that could be at play here. In the end, that money is due to the provider no matter how long it took them to send out the bills. Each of those patients knows they saw the doctor, and received notification from the insurance company that they had a balance due. If a letter is included with the statements explaining why it has taken so long to get the bills sent out that should alleviate some of the calls and questions. Remember, it is not likely that the doctor forgot to send the bills, it is more likely that a staff person did not send the bills out.

  8. #8
    Marion, OH
    I think you need to look at this as a customer service issue. If you send bills to patients that are 2-3 years old the patient IS going to be upset. You might have to ask your doctor, is the amount owed worth losing a patient over? If this is a patient that is seen on a regular basis, always pays their bills, and shows up to their appointments than it might not be worth losing this patient. You will get more money keeping them than you would losing them. If the patient is seen once every 2-3 years, never pays their bills, and no shows when they do have appointments, no loss if they find a new doctor. I personally do not think a patient should receive a bill after 12 months if they have never been contacted that there was a problem with their insurance.

  9. Default Patient Billing
    Thank You everyone that responded to my post.

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