Guest guest Posted July 24, 2012 Report Share Posted July 24, 2012 There are always options when it comes to billing. For a non par provider, you may not receive an explanation of benefits, but the patient will..., since they are in contract with the insurer. Since the auto is making this a precursor before paying, you will want to bill the patient with a letter explaining what is happening. We typically tell our patient that if they submit the EOB's, then we will pursue collection against the auto liability company as opposed to collecting from them. Jim Hall, CPA <///>< General Manager Rehab Management Services, LLC Cedar Rapids, IA 319/892-0142 X 110 visit our webpage at: www.rehabmgmt.com Recourse? The business manager of one of my clients spoke with the adjuster to verify eligibility on an auto claim. The adjuster stated that the policy was NOT coordinated. After submitting billing, I received EOBs asking for the health insurance carrier EOB. I called the auto carrier, and they are now stating that the policy IS coordinated. My provider does not participate with the patient's primary plan, so will not be able to pursue payment from them. Does the provider have any recourse? Aldridge Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 24, 2012 Report Share Posted July 24, 2012 There are always options when it comes to billing. For a non par provider, you may not receive an explanation of benefits, but the patient will..., since they are in contract with the insurer. Since the auto is making this a precursor before paying, you will want to bill the patient with a letter explaining what is happening. We typically tell our patient that if they submit the EOB's, then we will pursue collection against the auto liability company as opposed to collecting from them. Jim Hall, CPA <///>< General Manager Rehab Management Services, LLC Cedar Rapids, IA 319/892-0142 X 110 visit our webpage at: www.rehabmgmt.com Recourse? The business manager of one of my clients spoke with the adjuster to verify eligibility on an auto claim. The adjuster stated that the policy was NOT coordinated. After submitting billing, I received EOBs asking for the health insurance carrier EOB. I called the auto carrier, and they are now stating that the policy IS coordinated. My provider does not participate with the patient's primary plan, so will not be able to pursue payment from them. Does the provider have any recourse? Aldridge Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 24, 2012 Report Share Posted July 24, 2012 But because we are in Michigan, and the patient has a coordinated policy, the auto carrier is not responsible for paying on the claims if the patient goes to a provider outside of the network of their health insurance plan. If the provider had know that the policy was coordinated, they would have referred the patient to another provider unless the patient agreed to and could pay cash. > > > > > There are always options when it comes to billing. For a non par provider, you may not receive an explanation of benefits, but the patient will..., since they are in contract with the insurer. Since the auto is making this a precursor before paying, you will want to bill the patient with a letter explaining what is happening. We typically tell our patient that if they submit the EOB's, then we will pursue collection against the auto liability company as opposed to collecting from them. > > Jim Hall, CPA <///>< > General Manager > Rehab Management Services, LLC > Cedar Rapids, IA > 319/892-0142 X 110 > > visit our webpage at: > www.rehabmgmt.com > > > > > Recourse? > > > > > The business manager of one of my clients spoke with the adjuster to verify eligibility on an auto claim. The adjuster stated that the policy was NOT coordinated. After submitting billing, I received EOBs asking for the health insurance carrier EOB. I called the auto carrier, and they are now stating that the policy IS coordinated. My provider does not participate with the patient's primary plan, so will not be able to pursue payment from them. Does the provider have any recourse? > > Aldridge > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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