Claims and deductable
Can we edit the claim field #29 "Amount paid" and then submit it to the insurance company, to let them know the client already paid the deductible amount in full, and they can adjust the deductible accordingly or do we need to wait till they send the EOB back with "client owes"?
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Box 29 is not required, and SimplePractice defaults the field as blank. Even if you've collected a copay, coinsurance, or deductible in advance, SP does not automatically fill in Box 29. I think this is because even if the client paid you in advance, and you note this on the claim, it has no bearing on how the insurance company processes the claim. The deductible and other out-of-pocket expenses (copays and coinsurance) are applied by the insurance company in the order the claims were received and processed. Regardless of whether or not the deductible was paid in advance, the EOB will simply state a "Patient Responsibility" of what they need to pay you. The insurance company does not care if you were able to collect that money or not.
I don't think it's an issue with the insurance company if you leave it blank, even if you collected a fee from the client. I sure hope not, because it would be a big pain to have to manually input every copay that was collected since SP doesn't do it automatically.
I think the only time it would be an issue is if Box 27, Accept Assignment, is checked "Yes", and you collect more than is allowed. If you are filing the claim as an in-network provider, this box should be checked "Yes" because you agree not to charge the client more than the insurance company deems is an acceptable rate. If you collect a rate higher than what the insurance company deems acceptable, this would be a red flag.
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