Lori Posted Wed 14th of August, 2013 13:33:06 PM
A patient has $89.00 balance going to their yearly deductible and the office would like to make some adjustments to the $89.00... can we do this?? would the adjustment be considered insurance fraud??
SuperCoder Answered Thu 15th of August, 2013 16:19:07 PM
This depends on their contract with the insurer. Since pediatric practices aren't usually contracted with Medicare (and we usually quote Medicare rules), that doesn't apply in this case. Some insurers do allow such adjustments, while others do not.