Magazine article Clinical Psychiatry News

ACA Insurance: Will You Get Paid for Care?

Magazine article Clinical Psychiatry News

ACA Insurance: Will You Get Paid for Care?

Article excerpt

Will you get paid for the care you provide to patients who have gained insurance coverage through the Affordable Care Act's health insurance claims? You'll soon find out.

Under the health reform law, patients must pay their first month's premium to be considered enrolled; they then have 90 days to pay the next premium. If the patient doesn't pay his or her premiums for the second month, the insurer can hold or "pend" all claims. By the third month, if the patient still has not paid, the insurer can terminate his or her policy. The physician is left: to collect whatever is owed for all outstanding claims.

The Centers for Medicare & Medicaid Services clarified the grace period policy in a letter to insurers last year. The first ripples could come this month. Patients who started and paid for coverage in January, but who did not pay in February or March, might get dropped from coverage. That could leave physicians scrambling to cover the unreimbursed care. …

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