What happens when patient-paid amount is equal to the total claim amount?

Last Updated March 2nd, 2017

If you’re submitting claims for cases where a patient pays in full for the service ($0 claims) and want the service(s) contributed toward the patient deductible, and patient has not yet met their deductible, the final claim status result will usually return the claim is finalized and denied since the trading partner didn’t pay but the applied_to_deductible value will be set to true.


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