tci Part B Insider - 2013 Issue 11
Reader Question: Non-Par Medicaid? Bill the Patient
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Article Overview
This article addresses a common office-billing scenario involving patients whose insurance status changes before or after a visit and how a non-participating practice may respond. It is aimed at medical office staff, billers, and practice managers who handle eligibility, patient balance billing, and account follow-up. The guidance focuses on general billing workflow, patient notification, and insurance verification practices rather than on clinical care.
Why This Topic Matters
Coverage changes can create denied claims, patient balance disputes, and office workflow issues. This article helps readers determine whether the situation is relevant to their billing process and what general administrative considerations are discussed.
What You Will Learn
- How coverage changes can affect billing workflow in a non-participating practice
- Why insurance verification before the visit can matter for recurring coverage problems
- What general follow-up options may be discussed when a claim is denied and the practice does not participate with the payer
- How patient notification and account handling are framed in an office billing context
Who Should Read This
- Medical billers
- Coders
- Practice managers
- Front-desk staff
- Revenue cycle personnel
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