Billing Insurance for Family
Can a chiropractic physician treat a family member and bill the charges to an insurance company?
When you treat family, often your family will want to help you out and suggest that you file the claim for services with the insurance company. Whenever you are going to file a claim for services rendered to family members, always check the policy first.
Most Blue Cross policies prohibit charging for treatment to members of the immediate family. Blue Cross defines immediate family members as:
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- Current spouse
- Eligible domestic partner
- Parents and step-parents
- Children and grandchildren
- Siblings (including natural, step, half or other legally placed children).
If it is determined that a claim has been paid in error, Blue Cross will request a refund of the payment. Keep in mind that Blue Cross can ask for repayment for services rendered over the eighteen months.
Medicare does NOT pay for charges by immediate relatives of the beneficiary or by members of his/her household. Medicare defines immediate relatives as:
- Husband and wife
- Natural or adoptive parent, child, and sibling
- Stepparent, stepchild, stepbrother, and stepsister
- Grandparent and grandchild; and
- Spouse of grandparent and grandchild.
What is interesting is that Medicare states that “this relationship continues to exist even in the case of divorce.” Keep in mind that Medicare can ask for repayment for services rendered over the last three years.
