I work for a Medical Billing Company in West Tennessee. We have client’s whose providers are not enrolled with some payers (Medicaids, Blue Cross, Cigna, Aetna, UHC) but these providers still see patients with plans they are not enrolled with. The client’s insist that we send claims for the unenrolled plans although we probably will not receive any reimbursement for these claims.
We have Enrollment edits in place that will not allow a claim to drop if the provider is not enrolled.
I would like to know how others are handling claim submission to payers that their providers are not enrolled with. Do you drop a claim, write off, etc?
Thanks,
TFaircloth