Author Topic: Gift Certificates  (Read 2768 times)

CJM

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Gift Certificates
« on: December 12, 2009, 11:22:58 AM »
If a patient uses a gift certificate given to them by our office, are we still allowed to bill their insurance company for the visit?

Steve Verno CMBS, CEMCS

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Re: Gift Certificates
« Reply #1 on: December 13, 2009, 12:41:13 PM »
What is the gift certificate for?
I'l have a double chubby chuck, a mexicali chilibarb, and two cherry cokes
Left hand Blue, Right Leg Green
You got your peanut butter on my milk chocolate.
Dont cut the blue wire! 
I love spam.

Michele

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Re: Gift Certificates
« Reply #2 on: December 13, 2009, 10:58:32 PM »
If you bill the insurance then I would think you could only apply the gift certificate to the patient portion.  Otherwise the service would be paid for twice, once by the insurance and once by the person who purchased the gift certificate.

Michele
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CJM

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Re: Gift Certificates
« Reply #3 on: December 17, 2009, 11:24:26 AM »
The gift certificates are for free exams and x-rays and were mailed to patients by our office.  I'm assuming that means I can't bill the insurance for the exams or any x-rays given.  That seems to be the logical thing.
This was the first time I've dealt with gift certificates so it threw me a bit and I wasn't quite sure what to do with them.
Thanks for your input!  It helped to clarify the situation.

Steve Verno CMBS, CEMCS

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Re: Gift Certificates
« Reply #4 on: December 19, 2009, 01:45:29 AM »
Thanks

If the certificate was for free exams and x-rays what were you wanting to bill to the insurance company?

If the doctor offered something for free, you cant charge the insurance company for the free item.  

He also has to be careful that the free offer isnt used as an inducement for self referral which could be a possible violation of the Stark Act.  It might be misinterpeted as a possible kickback even though it isnt.  It could be the interpretation alone.

Also be careful with unbundling such as taking XXX service which also contains yyyy, then offering yyy for free but billing xxx.
I'l have a double chubby chuck, a mexicali chilibarb, and two cherry cokes
Left hand Blue, Right Leg Green
You got your peanut butter on my milk chocolate.
Dont cut the blue wire! 
I love spam.

Medical Billing Forum

Re: Gift Certificates
« Reply #4 on: December 19, 2009, 01:45:29 AM »

PMRNC

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Re: Gift Certificates
« Reply #5 on: December 29, 2009, 12:07:35 PM »
Lots of chiropractors do this and this could get very sticky. I remember that here in NY a provider got into big time trouble for offering a coupon right in the yellow pages. Medicare deemed it was indeed fraudulent the way he was offering it.
Linda Walker
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Re: Gift Certificates
« Reply #5 on: December 29, 2009, 12:07:35 PM »