We have gotten many phone calls from people who have had a family member that was in an inpatient drug and alcohol rehab facility that didn’t accept their insurance. Of course when the family member was admitted it was a crisis situation, and there was little choice as to what options were available. In many cases it is actually life or death. They certainly can’t be driving around looking for a participating facility.
The problem is that these out of network facilities require payment for the services up front. Since they do not participate with the insurance, they need to make sure they will be paid. The only real way for them to ensure payment is to get it in advance. Again, due to the situation, the family has no choice so they borrow, or charge, or whatever they need to do at the time.
The insurance companies usually require that the charges be submitted on a UB04 form, which is the universal claim form for facility billing. It isn’t that they don’t want to pay, but the information that they require is not on the walk out statement that the facility has provided to the patient. The facilities don’t know how to complete these UB04 forms, and they’ve already been paid. Many times they truly want to help the patient get reimbursed but they simply don’t know how.
We have found a way to help out both the patients and their families, and the facilities. Solutions Medical Billing Inc has teamed up with Xena health to provider a service of taking all of the necessary information from the facility and putting it on to a UB04 form to submit to the insurance carrier. Now patients have a way to get the proper forms filled out and submitted to their insurance carrier so that reimbursement can be made promptly. For more information on how this service works, visit www.facilitybilling.com
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