Wiki billing patients

[adaniel]

We provided a vaccine for a patient that was going abroad & the insurance denied stating non-covered charge. The full amount was in the "amount allowed" column but zero listed in patient owes.... can we bill the patient?

Can we bill a patient if the service was provided and allowed by insurance, but non covered under their plan and not listed as PR.....?????

 

[jliving77]

No, you can't bill the patient for anything the insurance says they are not responsible for. The allowed amount just means that if the insurance was going to pay for the billed service, that would be the amount payable (less any copay/coinsurance/deductible). The vaccine could have denied for a number of reasons one being the dx code was invalid. Was there a reason given on the EOB as to why the claim didn't pay? Did you call the insurance to see why your provider wasn't paid?
Jennifer