Guest guest Posted April 19, 2001 Report Share Posted April 19, 2001 To the list: I am looking for HCFA's regulations concerning billing coinsurance and deductibles to the patient. Years ago this was covered in HIM 15, Section 300. I do not know how to negotiate HCFA's webpage in order to find this and would appreciate any insight from people who have access them frequently. In particular, I am looking for information that will suppport me with an HMO contract. Someone I know is being told by an HMO insurer they are under contract with that Medicare paid them more than their contract would have. Since they are the secondary insurance, they are refusing to pay any further amount because of this. In addition, they are stating that to bill the patient would be in violation of the contract. I am trying to review the HIM 15, section 300 to see if I can find verbage that would indicate not billing the patient in this case would be a violation of the Medicare regs. Any thoughts out there? And has anyone successfully fought this issue before? Thanks! Jim Hall, CPA <///>< General Manager Rehab Management Services, LLC Cedar Rapids, IA 319/447-5625 Visit our web page at: http://members.aol.com/jhall49629 Quote Link to comment Share on other sites More sharing options...
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