Ophthalmology and Optometry Coding Alert

Question: When we send a patient to collections because she hasn't paid her deductible or her copayment, should we notify her insurance company? Will notifying the payer help us collect at all?

Florida Subscriber

Answer: You can try notifying the insurance company, but your results will depend on the individual payer. Most insurance companies won't pay much attention to notifications from your office about sending beneficiaries to collections. The deductible and copay portion of the service is the practice's responsibility to collect. The insurance company cannot do much to help you and isn't likely to step in between you and the beneficiary.

Best bet: Send the patient to collections and follow the procedures outlined in your financial policy rather than involving the insurance company. If you decide to pursue the insurance company route, talk with your provider relations representative.

Tip: If you use a collection agency, make sure you use one that reports to all credit reporting firms. That way, when the patient wants a mortgage, new credit card, new car or something else important to him, he will need to clear up his credit, which will mean paying his debt to the practice.

-- Advice for You Be the Coder and Reader Questions provided by Maggie M. Mac, CMM, CPC, CPC-E/M, ICCE, consulting manager for Pershing, Yoakley, and Associates in Clearwater, Fla.