Wiki Newborn baby billing rules?

[ericalea187]

Hello,

If a newborn is being seen for established care in a PCP setting and has not been added to the health insurance policy yet, do we bill under the mother's name or do we load the baby's name? Do we load the name as 'baby girl/baby boy" and do we need to provide the discharge date from the hospital?

Thank you!

 

[Olivia.bennett1@aol.com]

Hello,

If a newborn is being seen for established care in a PCP setting and has not been added to the health insurance policy yet, do we bill under the mother's name or do we load the baby's name? Do we load the name as 'baby girl/baby boy" and do we need to provide the discharge date from the hospital?

Thank you

I work at a peds clinic in OR and we hold the encounters until we see the baby has a CCOA. We make a task in the babies chart and follow up weekly on MMIS to F/U on the status. We stopped adding DMAP as that's usually what babies get put on first before a CCOA like Pacific source community solutions but they retro back to DOB once they put them on a CCOA we've noticed and also we ended up having a huge issue so we just waited for the CCOA before billing. Its not that you can't bill under mom's just every clinic has different preference's. We do not as it is created an issue along with billing DMAP when they got open card instead of waiting for them to be placed on a CCOA.

 

[rthomas@impcna.com]

Hello,

If a newborn is being seen for established care in a PCP setting and has not been added to the health insurance policy yet, do we bill under the mother's name or do we load the baby's name? Do we load the name as 'baby girl/baby boy" and do we need to provide the discharge date from the hospital?

Thank you!

In our practice, a newborn is considered Self Pay. We give the parent until the 2-month WCC to get the baby added to health insurance. If there is still no active coverage at the 2-month WCC, payment for the 2-month WCC is required prior to the visit and past balances are to either be paid or set up on payments.