MAY 13, 2021
Patient Status When Billing Different Payers
Question: A patient has not been seen for medical exam for five years but presents two years ago for a routine vision billed under their vision plan. Today the patient returns for a medical exam billed under the medical insurance. Does the routine vision reset the new patient clock so today’s medical exam can be billed as a new patient exam?
Answer: Today’s medical exam should be billed as an established patient of the practice. The different insurances (vision/medical) do not change the patient's status or if the patient changes insurance carriers. Hopefully, the vision plan exam was submitted as a new patient.