New Evaluation When Patient Changes Insurance
As we begin the new year, some of your patients who began therapy prior to January 1, 2025 will have a different insurance for dates of service on and after January 1, 2025. That leads to a frequent question I receive. When a patient switches insurance during an episode of outpatient therapy, is a new evaluation required?
In this article, I will answer the following questions:
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Thank you, this article, like most all your articles, was very helpful.
You are welcome and thank you for the kind words!
Thanks for this clarification. Does this apply to those billed using a 1500 form or does it apply / also apply to those nursing home residents where billing is on a UB04?
Answers apply to all outpatient therapy regardless of claim form used.
What about for Medicaid policies? Are new evaluations required yearly if a patient switches from one Medicaid insurance to another?
The answer to question #1 would apply.