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What else can I help you with?
Does a provider have to bill secondary insurance even if the patient prefers to pay out of pocket?
If the provider is out of network or not contracted with the secondary insurance, they do no have to bill the secondary and the patient is responsible for the balance (if any) owing
Can an In Network provider offer a discounted Self Pay package to a patient as an alternative if they are contracted with their insurance company?
In most cases the provider can not. The provider is obligated to bill the insurance. The reason is such transactions can lead to insurance fraud.
Can a medical provider bill the patient the difference insurance company pays?
No, they shouldn't be billing you for the provider discount if the hospital is contracted with the health insurance plan.
Can a noncontracted hmo provider bill a patient?
AnswerYes. "Non-contracted" means there is no contract with the insurance company to prevent the doctor from billing whatever he likes.
Can a provider bill the patient though he is contracted with local blue cross if patient has an out of state plan?
Providers who are not "in network" for the particular version of Blue Cross cannot be sure of being reimbursed for treatment they provide. Thus, they must bill the patient, who then takes on the responsibility of dealing with the insurance. Most providers will assist with this, if asked. This is an issue with the insurance company, not with the provider.
How much is a patient liable to pay for surgical procedures?
You would have to look at the summary page of your policy. Whatever the insurance company says you have to pay.... or if the provider is not contracted, whatever they want to bill you.
When a primary insurance payer pays 0 on a 1000 bill and a secondary pays 700 with a 700 contracted amount do you have to pay the difference 300?
With out a doubt...yes. Unless your dentist is a contracted provider through your insurance company, in that case they might have to adjust your account to what the contracted (allowed) fee is per the insurance company. If they are not a contracted provider they don't have to adjust one dime!
What happens if doctors dont send bill to insurance in time allowed?
If the provider exceeds timely filing limits with the insurance carrier the provider cannot bill the patient. The provider must have a participating contract with the insurance carrier also.
How do I bill an insurance company?
To bill an insurance company, you typically need to submit a claim form with details of the services provided to the patient. This form should include the patient's information, the healthcare provider's information, the services rendered, and the costs involved. The insurance company will then process the claim and reimburse the healthcare provider accordingly.
When insurance pays provider the allowed amount can provider bill patient for the discounted amount?
Only if the physician is a non-participating provider who does not accept assignment. The physician can bill the patient the difference between the actual charge and the allowable charge. This is called "balance billing".
If a patient does not inform us he has medicaid is he responsible for the bill?
In Illinois, if the provider did not accept the patient as a Medicaid patient, the provider may bill the patient.
Is a provider RESTRICTED BY LAW FROM BILLING A PATIENT IF THE PATIENTS INSURANCE CARRIER DEIES THE CLAIM PER timely filing agreement?
Yes per the provider contract, they are required to file claims to the insurance carrier within specifiec time periods. The provider can NOT bill the patient if they have not done so.
