Forum - Questions & Answers
Self Pay Crisis
A patient intially gets registered as SELF PAY back in 2008...6 months into 2009 this patient states that as of 1/1/09 now has medical insurance with United Healthcare. So, all our charges from Jan thru March were denied for timely filing.
The patient never paid on these claims.
Our question is...can we bill the patient for these charges as we originally had her labeled as "self pay"?
Your input is appreciated.
OOps
If you are contracted with UHC, you are bound by that. Once you found this out, and filed a claim you kind of shot yourself in the foot!
YOu can try the appeal stating the patient did not give you the insurance info but I don't know if it will work.
Does the insured work for a large employer? If they are self-funded, you can send a letter to the Benefits Administrator and ask them to pay the claim.
My business is Claims Advocacy. I run into these situations where I appeal the claim for the patient. But since I am advocating for the patient, the Provider is usually out of luck in these situations
But I am telling you this so you can try the same technique in your Provider's behalf.
Another suggestion is turn around claims and patient statements faster so hopefully the patient calls in time to tell you he has insurance.
Good Luck