Revenue Cycle

Billing post-denials

Patient Financial Services Weekly Advisor, April 3, 2009

This week included April Fools’ Day, but denials are no joke to your facility. Check out this question that has gotten the most hits on our Patient Access Resource Center:

A patient came into the office and gave us Anthem Blue Cross and Blue Shield insurance card, so we billed that insurance. Blue Cross denied stating that the patient wasn’t eligible then we billed the patient. The patient comes back after a year later and says, “Oh, by the way I had Cigna insurance.”

So, we bill Cigna insurance, and we get denials stating that it is past timely filing, which we knew would happen.

My question: Is it legal to bill the patient after receiving these denials from Cigna and make them responsible for paying us services rendered? Or, is there a law that forbids us from doing so?

Editor’s note: To see the post, go to the Patient Access Resource Center.

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