Important Notice: Our web hosting provider recently started charging us for additional visits, which was unexpected. In response, we're seeking donations. Depending on the situation, we may explore different monetization options for our Community and Expert Contributors. It's crucial to provide more returns for their expertise and offer more Expert Validated Answers or AI Validated Answers. Learn more about our hosting issue here.

What if the child or their parents/guardians don’t know if the child is underinsured and the provider finds out only after the claim is submitted and payment is denied?

April 26, 2017child claim don’t guardians Parents payment Provider submitted underinsured

0

Posted

What if the child or their parents/guardians don’t know if the child is underinsured and the provider finds out only after the claim is submitted and payment is denied?

1 Answer

0

Posted

Once the insurance responds and payment is denied, the child’s status can be changed to underinsured in the record. The child should only be billed the maximum Centers for Medicare and Medicaid Services allowed amount for an administration fee (currently $15.60).