You Be the Billing Expert:
Do You Bill the Payer After Benefits Run Out?
Published on Tue Sep 22, 2009
Question:
A patient who is receiving mental health services has used up all his benefits. Therefore, the insurance states that the patient is responsible for payment. I am under the impression that even though benefits have run out I still need to bill the insurance company for proof that we billed the payer and that the patient has in fact exceeded his benefits. Is it legal to stop billing the insurance company and straight bill the patient? North Carolina Subscriber
Answer:
Turn to page 79 to see if you're up to speed on whether or not you should continue sending the payer a bill once a patient has exhausted his benefits.