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Whose responsibility?

Vaida Posted Sat 22nd of November, 2014 11:45:29 AM

Hi. I do billing for an office who constantly fail to get authorizations for in office procedures. They asked me to bill patients for denied claims with lack of authorization. Is this legal?

SuperCoder Answered Mon 24th of November, 2014 10:40:57 AM

Thanks for your question. Ultimately it is the patient's responsibility to ensure that the services that they are receiving are covered and to also make sure that authorization is or is not required. Provider offices generally complete authorizations for the patient so that all of the pertinent information is relayed to the insurance company accurately. This ensures that the authorization will be approved and that payment will be issued. It is not illegal to bill the patient but it should definitely be included in the practice's policy. Hope this helps.

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