kadiah Posted August 8, 2019 Share Posted August 8, 2019 So the "Urgent Care" (we're honestly just walk in clinics because most of us don't even have x-ray available 24/7) I work for is run by a huge non-profit group. They've told us that we will NOT be participating with any auto or worker's comp insurance, BUT if someone comes to us and demands to be seen for a problem relating to these two things, to let them know we don't participate and bill their health insurance instead. I just don't understand how this isn't insurance fraud but every time we say it is, they tell us it's not. I don't even know who in my organization I would ask about this, because every time I ask administration they say "do what is right for the patient"... and I think sticking a patient with a $500+ bill is not right, when I can direct them to an Urgent care that DOES participate. Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted August 8, 2019 Moderator Share Posted August 8, 2019 no worries if they are demanding to be seen, have been told you do not take their insurance, and it will be billed under their health care that is fine Just do not lie in your note - put that the patient was hurt doing "xyz" it is an insurance issue, not a medical one and really is not a worry (I have seen WC companies deny claims, then patient goes under their own health insurance, files and appeal, and wins big time cause WC carries are scumbags some times....) Just see the patient, do good medicine and move on.,.... 1 Quote Link to comment Share on other sites More sharing options...
Cideous Posted August 8, 2019 Share Posted August 8, 2019 We have this all the time. We just tell the patient that their Ins company will prob deny the claim and they will be stuck with the bill. That's usually good enough for 90% of the people to say no thanks, but if they demand to be seen we see them. 1 Quote Link to comment Share on other sites More sharing options...
Hemmingway Posted August 12, 2019 Share Posted August 12, 2019 Yea we run into that as well. My UC also sees people who were in auto accidents and want to claim the bill on their car insuirance. I have advised we have no contractual relationship with auto insurance companies and no agreed rate so they are unlikely to pay it leaving the patient with a huge bill. Admin doesn't care. Bodies in the door and charges generated. As stated, while I think there may be an ethical issue, its insurance and doesn't have anything to do with me. 1 Quote Link to comment Share on other sites More sharing options...
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