PI Payment Question--Attorneys welcome to repond

[Guest guest]

Good afternoon, Listserve folks--In a nut shell:Patient rear-ended and injured; transported to local ER by ambulance from the scene of the collision.PI then seeks treatment for injury in my office.1st billing and docs sent; payment received with standard WC fee schedule deductions.2nd billing and docs sent and payment received, BUT---This time my payment is reduced by applying a "DEDUCTIBLE" reduction.Turns out this patient has a $250.00 policy deductible. Never ran into that before.AND they only reduced the 2nd payment to my office by a little over $101.00.So if there IS a deductible, why didn't they take the entire $250.00?Further, WHY DIDN'T THEY TAKE THE ENTIRE $250.00 DEDUCTIBLE OUT OF THE INITIAL MEDICAL CONTACT ER BILL in the first place?Office manager got nowhere with the adjuster who argued that it was our responsibility to collect the deductible from this patient.The adjuster also said maybe they might have 'missed' the deductible, and so applied it later in the flow of things.REALLY?This situation is a 'first timer' in my office. Has anyone heard of this?As Vern would say, "What say ye??"Thank you ahead of time for your help.Ann , DC

[Guest guest]

Geez….what next…no I’ve never seen nor heard of such an animal….I have no idea….time for one of our attorneys to chime in…..Vern SAboe From: oregondcs [mailto:oregondcs ] On Behalf Of bluepearl2001@...Sent: Tuesday, April 24, 2012 2:13 PMTo: oregondcsSubject: PI Payment Question--Attorneys welcome to repond Good afternoon, Listserve folks--In a nut shell:Patient rear-ended and injured; transported to local ER by ambulance from the scene of the collision.PI then seeks treatment for injury in my office.1st billing and docs sent; payment received with standard WC fee schedule deductions.2nd billing and docs sent and payment received, BUT---This time my payment is reduced by applying a " DEDUCTIBLE " reduction.Turns out this patient has a $250.00 policy deductible. Never ran into that before.AND they only reduced the 2nd payment to my office by a little over $101.00.So if there IS a deductible, why didn't they take the entire $250.00?Further, WHY DIDN'T THEY TAKE THE ENTIRE $250.00 DEDUCTIBLE OUT OF THE INITIAL MEDICAL CONTACT ER BILL in the first place?Office manager got nowhere with the adjuster who argued that it was our responsibility to collect the deductible from this patient.The adjuster also said maybe they might have 'missed' the deductible, and so applied it later in the flow of things.REALLY?This situation is a 'first timer' in my office. Has anyone heard of this?As Vern would say, " What say ye?? " Thank you ahead of time for your help.Ann , DC

[Guest guest]

There are certain policies that have deductibles for PIP and $250 is typical.

We have seen it for a few years now.

dan miller

>

> Geez….what next…no I’ve never seen nor heard of such an animal….I have no

idea….time for one of our attorneys to chime in…..Vern SAboe

>

>

>

> From: oregondcs [mailto:oregondcs ] On Behalf

Of bluepearl2001@...

> Sent: Tuesday, April 24, 2012 2:13 PM

> To: oregondcs

> Subject: PI Payment Question--Attorneys welcome to repond

>

>

>

>

>

> Good afternoon, Listserve folks--

>

> In a nut shell:

>

> Patient rear-ended and injured; transported to local ER by ambulance from the

scene of the collision.

>

> PI then seeks treatment for injury in my office.

> 1st billing and docs sent; payment received with standard WC fee schedule

deductions.

>

> 2nd billing and docs sent and payment received, BUT---

> This time my payment is reduced by applying a " DEDUCTIBLE " reduction.

>

> Turns out this patient has a $250.00 policy deductible. Never ran into that

before.

> AND they only reduced the 2nd payment to my office by a little over $101.00.

> So if there IS a deductible, why didn't they take the entire $250.00?

> Further, WHY DIDN'T THEY TAKE THE ENTIRE $250.00 DEDUCTIBLE OUT OF THE INITIAL

MEDICAL CONTACT ER BILL in the first place?

>

> Office manager got nowhere with the adjuster who argued that it was our

responsibility to collect the deductible from this patient.

> The adjuster also said maybe they might have 'missed' the deductible, and so

applied it later in the flow of things.

> REALLY?

>

> This situation is a 'first timer' in my office. Has anyone heard of this?

> As Vern would say, " What say ye?? "

>

> Thank you ahead of time for your help.

>

> Ann , DC

>

>

>

>