PAYMENT MADE TO PATIENTS BY THE NON CONTRACTED CARRIERS

DESCRIPTION OF THE ISSUE

Dr.  is non-par with Blue Cross Blue Shield, so the Hospital claims which were billed to the carriers were reimbursed to the patients directly.  Since there are no payments received from the patients we are unable to collect those payments from the patients.

CONCEPT
In order to received payments from the carrier, the provider should be contracted with the Carrier.

REASON
Since we are unsuccessful in retrieving patient payments through statements we are waiting for the documentation process to get completed with the Collection Agency for further go.

1 comment:

Anonymous said...

If services were provided to a patient and the service provider is contracted with the insurance but NOT with that state's plan (ex. Blue Cross and Blue Shield of Illinois, when the patient is in Louisiana) and payment is made directly to the patient, then the service provider can contact/collect payment from the patient. The account can be sent for outside collections from a collections agency accompany with proper documentation that the insurance company paid benefits to the patient directly.

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