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Question about responsibility to file

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  • bluewriter24
    If a patient is choosing not to use their insurance either because they would rather cash pay or because you are out of network with their insurance and then
    Message 1 of 2 , Mar 26, 2014
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      If a patient is choosing not to use their insurance either because they would rather cash pay or because you are out of network with their insurance and then you become in network with that insurance at a later date, are you required to file with their insurance after you become in network even if they don't want you to? This of course excludes Medicare and Medicaid, in which I know the answer would be yes. Thanks.
    • Candice Aryitey
      I m not sure if I am entirely correct on this, but we interpret our contract based on our status at the time services were rendered. We would file the claim as
      Message 2 of 2 , Mar 26, 2014
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        I'm not sure if I am entirely correct on this, but we interpret our contract based on our status at the time services were rendered. We would file the claim as a courtesy to the patient if they requested it. Also, if our participation was backdated, we may take a look to see if any outstanding balances could possibly be covered and file them just based on the possibility of payment. But, we wouldn't automatically go back to file the claims.  Hope that helps.

        From: "bluewriter24@..." <bluewriter24@...>
        To: MedicalBillers@yahoogroups.com
        Sent: Wednesday, March 26, 2014 11:10 AM
        Subject: [MedicalBillers] Question about responsibility to file
         

        If a patient is choosing not to use their insurance either because they would rather cash pay or because you are out of network with their insurance and then you become in network with that insurance at a later date, are you required to file with their insurance after you become in network even if they don't want you to? This of course excludes Medicare and Medicaid, in which I know the answer would be yes. Thanks.
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