Who bills the member for deductibles and co-pays?
The client sends ACS an explanation of benefits (EOB) with their payment, indicating patient responsibility (deductibles, co-pays, co-insurance, etc). The client also sends the member an EOB showing the patient responsibility detail and payment to ACS for that providers service. ACS then mirrors the client EOB, and sends the provider an ACS EOP along with the ACS contracted payment minus the patient responsibility. The provider is responsible for billing the member for the patient responsibility. ACSs contract language prohibits providers from billing above the stated patient responsibility. Balance billing is prohibited.
