The Difference Between Billing With and Without Insurance

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January 5, 2018 | Aptus Associates

Medical clinic and hospitals like yours have a duty to provide their services to sick people, regardless of whether they have insurance or not. Although you’ll surely take their information, billing won’t come until the treatment is complete and the person is well again. Whether your patient has insurance or not will determine how you bill them. Let’s look at the different ways this can occur.

When a person checks in, they should present their insurance card. This helps both parties know what to expect from the visit, as not all plans cover all services. This will also provide your clinic with all the information you need to make an insurance claim against this patient’s policy.

The patient will be responsible for charges their insurance company does not authorize or cover. Many know what their co-payments are but probably couldn’t tell you exactly what their insurance policy covers. You may want to recommend to them when they call to schedule their appointment that they contact the insurance provider to discuss their planned visit and what their plan allows. This will prevent a surprise bill in the mail. If their insurance plan does not cover all of the services you rendered, they are financially responsible for the rest of your charges.

If they have no insurance at all, they can still be seen by your medical staff and the bill will be sent directly to them. This is somewhat easier for your Billing Department because they do not need to worry about the correct billing and insurance codes.

With or without insurance, billing takes a while to get it right. Does it sound confusing? Time-consuming? Like something you’d rather not do? That is precisely what Aptus Associates, LLC is here for! Aptus offers a complete Billing and Accounts Receivable Management package to primary care and specialty practices, rural health clinics, professional radiology practices, palliative care offices, and hospitals. We will handle the insurance company, or even billing the patient directly, for you!