Cavalier40
Guest
I work in a substance abuse rehab. We have clients who can stay in treatment as long as 6 months depending on some issues. Since we are out of network with out local blue, FEPs will always pay to the patient (among other policies under ERISA who do not have to follow the state assignment law) Our main concern is FEPs who actually pay to the policy holder. If they take the money (which can be in the tens of thousands of dollars) and run, are they committing a crime? Are we able to approach a District Attorney? Or is the only thing we can do is bill the treatment and report to a credit agency? I can see not making a big deal when dropping a balance to patient responsibility because of insurance non payment, however in this case the insurance did pay, they just did not pay the provider.
This effects some of our patients because if their parent is the policy holder, the check is cut to them. They can spend all of the money while their child is in treatment which actually puts the financial responsibility on the patient since they are the ones receiving the services. The policy holder is also not the one signing the legal documentation that the patient signs while in treatment such as the financial responsibility agreement.
In our past we have had people buy cars, new teeth and worst of all take the money to buy drugs and relapse. While a federal assignment law is a pipe dream, there has to be a way to protect providers from those who steal this money other than not admitting them into our center.
Any insight on this would help.
This effects some of our patients because if their parent is the policy holder, the check is cut to them. They can spend all of the money while their child is in treatment which actually puts the financial responsibility on the patient since they are the ones receiving the services. The policy holder is also not the one signing the legal documentation that the patient signs while in treatment such as the financial responsibility agreement.
In our past we have had people buy cars, new teeth and worst of all take the money to buy drugs and relapse. While a federal assignment law is a pipe dream, there has to be a way to protect providers from those who steal this money other than not admitting them into our center.
Any insight on this would help.