Wiki No fault won't pay driver was drinking

[jgielow]

OK I have a patient that was driving drunk when they were injured in a motor vehicle accident. Under NYS no fault, their insurance company is not required to pay. I billed them anyway and course they denied payment. This patient has straight Medicaid, will Medicaid pay for these office visits? If they will, are there any modifiers I need to add to signify no fault denied? Please help!!!

 

[CodingKing]

Send the claim to medicaid with copy of denial from primary.

 

[alician]

I agree, send it to the patient's private insurance, with a copy of the NF denial. They may still deny it stating it's liability of the NF carrier, but if they do, it should come back with a PR denial, and you should be able to hold the patient responsible.