Thursday, June 20, 2019 3:04:24 PM
you have a service that is $100 - doesnt really matter what is charged the all important figure is what is allowed.
so it doesnt matter what the figure is that is billed it is meaningless
so out of the $100 typically an insurance will allow lets say 20%
( lab bills are notoriously high and a lot is written off but dont take my word for it look at some lab bills you or someone you know may have gotten)
so out of the $100 they allow $20 and typically pay 80% of that
the balance is due from either the patient ( if they no supplement insurance ) or the secondary insurance - in many cases the secondary isnt billed so it has to be rebilled with the original bill and the payers eob explanation of benefits showing what was allowed and paid )
so, if there is a a balance it has to be collected. Does ARYC do this as the lab is responsbible for sending out bills. Do they have an accts
receivable dept - for this many alleged dollars at least 20 people would be needed. Do they have a billing system?
AND MOST IMPORTANT - did they have a provider number to bill - seems to me just a few weeks ago a company was hired to do their credentialing which means anything before that has a great likelehood of not getting paid as they didnt have a provider number.
so the alleged millions of dollars could be nothing if not credentialed or reduced substantially because that is how insurance works
hope this helps
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