Hello,
A private company that offers plans for patients that are found eligible for Masshealth (Medicaid) has been inconsistent with payment of services. We have quite a few patients that have claims that should be covered and the insurance company acknowledges their error in denying their claims, though many claims as far back as July of 2018 remain unpaid. They were incorrectly denied, for lack of prior authorization. Prior authorization is not required for first 20 visits of services we provide. Calls, emails and requested spreadsheets have not resulted in payment of all claims that the company agrees are correct and payable. Provider wants to bill patient. These are covered services. Can the office request payment from the patient?
A private company that offers plans for patients that are found eligible for Masshealth (Medicaid) has been inconsistent with payment of services. We have quite a few patients that have claims that should be covered and the insurance company acknowledges their error in denying their claims, though many claims as far back as July of 2018 remain unpaid. They were incorrectly denied, for lack of prior authorization. Prior authorization is not required for first 20 visits of services we provide. Calls, emails and requested spreadsheets have not resulted in payment of all claims that the company agrees are correct and payable. Provider wants to bill patient. These are covered services. Can the office request payment from the patient?