If physician's office closes your file but they are still awaiting payment of services will they no longer..

Question

accept insurance coverage from that time?

My daughter was sent to a specialist in October and in January we recieved a letter from medicaid stating that she WAS eligible for coverage in October, November and December and that services she received from that specialist are covered. I sent a copy of this letter along with my daughter's bill back to the physician's office and just received another bill for the same amount stating that they have closed her file.
No other information was included with this new bill except that now her file is closed. Are they saying they will no longer accept her medicaid? And why did they decide to close it after I submitted insurance information?
Is this usual policy for physicians offices?

Answer 1

Call your daughter's doctor's office and talk to them.

Answer 2

When you recieve a letter stating that the account is closed, it means that they have billed medicaid, been paid and you are not in the position of needing to pay.
Most offices do send a letter stating that you do not need to pay, but some over look this convience of thier patience.
After submitting the insurance form, they up date there system, file with the correct company, then go from there:in your case it was paid and closed.
Hope this helped....

Answer 3

They don't care WHO pays them! The question is, will they BILL the insurance. You will probably have to submit the bill to medicaid yourself.

Call the billing office, and call medicaid for a claims form. You'll likely have to go to the office in person to get them to sign off on the services rendered.

It isn't uncommon for a doctor's office to only submit the bill ONCE, and if it gets denied, to then refuse to submit it to the insurance company again. Then it becomes YOUR responsibility to submit it to the insruance company.

They probably closed it because they got a denial letter from Medicaid - maybe the paperwork hadn't caught up yet.

Answer 4

Doctors' offices have to adhere to what's called a Timely Filing Rule. It's a rule placed on providers by insurance companies stating how long a provider has to file a claim. Most plans it's 45 days - including Medicaid in NY. Therefore, since you didn't provide them the information until January, it's probably too late for them to bill the insurance for an October visit.

What you should do is contact your caseworker and ask them to put the claim in for processing themselves. Technically, since you didn't give the doctor's office the insurance information promptly (I realize you didn't have it until recently), they can hold you responsible for payment or for making sure the claim gets paid.

Answer 5

Get a copy of the letter from your doctors office and then submit that too the medicaid office showing she is eligable. if you do this within so many days they will reopen the case. do it as soon as you can and don't wait.

Answer 6

You should call the physician's office and speak with the office manager. It is possible they turned it over to a collection agency and if that is the case your insurance carrier and the collection agency should discuss the issue between them.

Answer 7

Call their billing office and review this information with them. Often, doctor's offices have separate billing offices or subcontract with an independent medical biller so one may not know what another is doing. They may also have referred your file to collection so it's important to follow up with them.