Medical billing hodge podge thread.

jym626
Sat, 07 May 2016 01:46:33 +0000

Eyeamom is correct about the time for the initial filing of a claim. I thought you were asking about collections of claims. Apologies. IIRC, here, the time to file a claim was not a state regulation but rather each insurer had its time limit. In one case a patient changed insurers and didn’t tell us. The claim paid but then we were, sometime later, required to return the money as their first policy had termed. The patient was not very responsive to the billing office’s attempts to reach them and did not provide the new insurance until it was too late to file. And of course the patient was not interested in taking any ownership of this. Fun.

The “good news” is the insurance companies are only supposed to have 18 months to ask for repayment if a claim is processed incorrectly (i.e. They think they overpaid on a claim). But even though the provider can write to the insurance company if the request for repayment is beyond the 18 month period ( and even if their request is wrong) the insurance company can either simply withhold that amount from another patient’s claim or, since some insurance companies now require that they auto deposit into the provider’s bank account, they can just suck it right back out. Oh, and Medicare can apparently do an audit and if they think money is owed, they can not only suck it out of the business account, but any other personal account the dr has at that same bank. Many docs are now advised to set up their Medicare payment at a bank they have not other accounts with.

Fun, huh.