Wiki Past due accounts

[rchehey]

So I am running into an issue that I can't find an answer to.
I am currently in the process of bringing back billing to in-house instead of going through a 3rd party billing. I have been here for a year now so most of these errors are before my time.
We are sending out "pink slips" to outstanding accounts that owe from 2019 and past/ and early 2020 and that we have sent out more than 5 statements, without hearing back from the patient/them making a payment. Of course, now that we have threatened collections, we are hearing from patients to dispute their bills.
The problem is, a few of them are saying it should have been billed to insurance. I have no way of knowing if they have had these conversations in the past because the previous practice manager is long gone, and we have been using a 3rd party billing (and the transition was rough and still is) hence us taking it back.
In one instance, this is correct and it should have been billed to insurance but it was never added and processed. I know I have to bill it to the insurance and it will be denied for timely filing.
My question is, can we go after the patient for any of the loss due to the fact we have sent out so many statements and they haven't said anything, or is this a chalk it up to a learning experience, and follow up on outstanding accounts well before timely filing so this doesn't happen again (which we will be doing now)?

 

[wlf78911]

"this is correct and it should have been billed to insurance but it was never added and processed. I know I have to bill it to the insurance and it will be denied for timely filing."
-You can not go after patient if service was never billed to insurance or denied for timeliness.

What we have done with our practice when we took billing back from someone else. We went through each statement for accuracy(co-payment, deductible, co-insurance), rebill patient once past due balance with delinquent account notification, if we do not received any responses, next billing cycling we forwarded to collection agency. We did had a response letter all the way from Japan letting us know that he/she no longer live in the State so we just adjust those fee off.

Wish you luck on the transaction!

 

[csperoni]

If you knew about the insurance within the timely and there was some reason it was not billed to insurance, I would not hold the patient responsible. If due to the transition, you cannot determine if the patient informed you, I would consider it a learning experience. I almost never submit an account for legal collection that was disputed by the patient. There are rare instances where the patient disputed, and was clearly 100% incorrect that I would submit for collections. But with gray areas, I am much less prone to legal action.
I would assume if the patient is contacting you now, and actually did have active insurance at the time, it is likely the patient previously supplied the info. A patient who ignored the previous bills is much more likely to ignore your current ones (even with threats). If you have no way of knowing whether or not the patient did previously supply info, I might simply ask the patient when calling now - "Do you recall when/who you supplied the info previously?" and take them at their word since I cannot dispute what they are stating. If you were able to get the info from your previous 3rd party billing, and could dispute it, that would be different.
Whenever there is a transition such as this, I am typically more focused on correcting things now and making sure moving forward is done better. No one can go back in time to fix an error from 2 years ago.