Patient Sheila Morris was in to see Dr. Sullivan on 1/5/18. She had…

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Question Answered step-by-step Patient Sheila Morris was in to see Dr. Sullivan on 1/5/18. She had… Patient Sheila Morris was in to see Dr. Sullivan on 1/5/18. She had an office visit, EKG, and a minor procedure performed in the office totaling $600. Dr. Sullivan is contracted and in-network with Ms. Morris’ insurance carrier. The insurance carrier has a 90-day claim submission policy from the date of service. When reviewing the accounts receivables at the end of May, the billing department discovered that the claim for Ms. Morris’ 1/5/18 visit was never submitted to the insurer. The billing department submits the claim on 5/20/18 in attempts to collect any amount. However, due to the insurer’s submission policy, the claim is rejected and they will not pay for the claim. – Defend whether or not the patient should be responsible to pay for all or part of the services rendered.- Analyze what the ramifications might be for that decision.- Explain if the practice can even appeal the denied claim.- Lastly what would be a plan so this circumstance can be avoided in the future?  Health Science Science Nursing MDAA 202 Share QuestionEmailCopy link Comments (0)

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