Docs Urge CMS to Require Issuers to Notify Them of a Patient’s Grace Period Status

Physician groups throughout the nation want immediate notification when patients insured under the health exchanges enter the 90-day grace period for nonpayment. Physicians urge CMS to shift the burden and risk of potential loss for patient non-payment of premiums back to the patients. Currently, issuers are responsible of paying claims incurred during the first month of the grade period, and they’re not required to inform providers of patients’ nonpayment until months two and three. Physicians believe that the notice requirements are inadequate and lead to administrative confusion, as well as disruptions in office workflow, where practice employees spend multiple hours on the phone with insurers attempting to verify coverage and payment status. Providers urge “CMS to require issuers to notify them of a patient’s grace period status as part of the insurance eligibility verification process.”

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