Paid to Patient Insurance Claim Recovery

What is it?

A Paid to Patient Insurance Claim is a healthcare claim that is physically paid out to the patient or primary subscriber of a healthcare insurance policy for services that an out of network provider billed on your behalf. Checks made out to the patient directly will start to arrive at the primary subscriber’s address from their health insurance company. An article from CNN describes how many problems this can cause for both patient and healthcare provider.

Why Does it Occur?

Paid to Patient Insurance Claims happen when a patient utilizes an out of the network provider and charges their insurance policy for the claim. The insurance policy itself covers such services because of out-of-network benefits. Still, the insurance carrier sends the payments to the patients themselves so that the healthcare provider is penalized for providing services to someone outside their network and forces the healthcare provider to track down the funds.

Who Does it Affect?

Paid to Patient Insurance Claims only happen to people who have out of network benefits on their insurance plan and have met their applicable deductibles. You can be sued in court by the healthcare provider for not returning these funds.

For the Healthcare provider, Paid to Patient Insurance Claims are prevalent in out-of-network clinical labs, out-of-network surgery centers, and out-of-network drug rehabilitation centers. Insurance carriers like Anthem and United Healthcare are notorious for sending patients checks for services rendered by out-of-network healthcare providers.

How Can We Help?

Amplicon has recovered $10 million plus in Paid to Patient Insurance Claims. Amplicon’s team has tools to undercover hidden paid to patient claims. Insurance carriers utilizes confusing billing remittance codes that cause most healthcare billing teams to ignore it as a non-paid claim when in reality the patient has the checks. Amplicon’s Paid to Patient Insurance Recovery services provide the following:

  • Skip Tracing Services- Ensuring the most accurate demographics data

  • Phone Campaign

  • Text Campaign

  • Email Campaign

  • Mail Campaign

  • HIPAA Compliance

  • Debt Collection Compliance

  • Detailed Analytical Reporting

Why Hire Amplicon to help with Paid-to-Patient Insurance Clam Recovery

Amplicon’s team of experts deal with agents from healthcare insurance companies on a daily basis. Our knowledge of the process allows us to get insurance checks re-cut for claims that are up to 4 years old. If you’re ready to start collecting on your Paid to Patient Insurance Claims, Contact Us Now!

See our related services and blog post:

Work with Us

Amplify The Revenues of Your Healthcare Business

%d bloggers like this: