Sunday 29 March 2015

Claim processed as PR - 2 Coinsurance Amount


PR -  2  Coinsurance Amount

Coinsurance amounts are generally 20% of the Medicare fee schedule. Physicians must collect the unmet coinsurance from the beneficiary. Consistently waiving the coinsurance may be interpreted as program abuse. If a beneficiary is unable to pay the coinsurance, the physician should ask him or herto sign a waiver that explains the financial hardship. If no waiver is signed, the beneficiary ’ s medical record should reflect normal and reasonable attempts to collect, before the charge is written off.

Action :  

1. We need to file the claim to secondary insurance
2. If there is no secondary insurance we can bill the patient.

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