Medical Billing Forum
Billing => Billing => : isabelreyna October 10, 2014, 01:08:29 PM
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I am a billing service and about to sign a mobile phlebotomist but she is not sure how to charge for her service. So she ask me if
I find out for her she would give me the acct. Can a phlebotomist help me out. THANK YOU
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That is EXTREMELY vague.. it doesn't quite work that simple.
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thank you Linda, but what I really need to know, is does Medicare pay for the service of a mobile phlebotomist?
I just found out that they don't pay for mileage.
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Does she have an NPI? Is she a recognized service provider? These questions have to be asked first. As far as I can see most are cash pay, I would assume pricing has to be competitive since blood draws can be done at almost any provider.. sorry I can't be much help, I'm thinking they would need to be setup with NPI and of course a recognized provider, credentialed with other carriers if need be, to bill insurance direct. Most of ones I looked at online are self-pay.
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Yes, Linda she has an NPI and she is recognized, but as she keep informing me of her business is, can she collect money from a senior living facility, whatever Medicare don't pay?
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I don't see how she can collect money from a "senior living facility". What do you mean by that, exactly?
If the patient is in an SNF, they have people on staff to draw blood. If they are in an ALF, they usually also have people on staff to do blood draws, or the person has an HHA come in to do so. If it is a senior living community, with no medical component, then it is a home visit, and the person getting the blood drawn is responsible for payment of non-covered services.
The only situation where I can see someone needing a mobile phelbotomist is if they live in a private residence, have no HHA involved for whatever reason, and cannot or will not leave the house to go to their doctor, a lab, or a hospital for the blood draw. Which can't be very many people, in my opinion, but then again, I have never heard of this before now.
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Yes, Linda she has an NPI and she is recognized, but as she keep informing me of her business is, can she collect money from a senior living facility, whatever Medicare don't pay?
I'm with Kristen on this one.. I too am not understanding.. MEDICARE will not pay so really this might be a private pay situation ? the SNF will already have staff to draw blood.
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no the SLF does not have their own medical staff they always call a mobile unit and then the phlebotomist do there service and then the facility told my client to bill Medicare but can't bill the patient the reminder.
The facility have gone through many mobile units because of this. She want to hire my service so that she can bill Medicare and the reminder to the pt. Can we do that?
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Okay, let's look at this logically...if Medicare covers the service of a mobile phelbotomist(which I don't know that they do, and it appears that they do not, from what I have read), the billing would go to Medicare Part B, who would pay their 80%, then if there is secondary coverage, they would pay the remaining 20%, and the patient would not have a bill to pay. But if for some reason the secondary doesn't pay(deductible, for instance), then the patient has to pay the 20%. You can't just "not" bill the patient, unless they have a hardship form on file. So it sounds to me like the "senior living facility"(which I still don't know what that is...do you mean an ALF?) is trying to tell the previous mobile phelbotomists and your potential client to do something illegal, in writing off the balances across the board. Which is why the previous ones stopped their services to this particular facility.
So to answer your question, yes, if the service is covered by Medicare, and they pay, but the secondary doesn't, it becomes patient responsibility, and the phelbotomist can and absolutely should bill the patient the remainder. But I would be hesitant if I was the phelbotomist to get involved with a facility that is basically telling her to do something illegal, by not billing the patients.
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thank you Kristin, this is what my potential client is telling me. The facility call the phlebotomist to draw blood but the senior living facility told my client that should needs to bill Medicare but Medicare only pays $3 or $4 for the service. I suggest to bill the patient for the rest. My client told me that the senior living facility told her that under no circumstance should she bill the patient. We believe that the facility bill the patient for the balance but we are not sure. this is what my client is telling me. So am I right bill Medicare, they only going to pay 3 or 4 and then I can bill the patient under normal circumstance? THANK YOU EVERYBODY FOR ALL YOUR HELP.....
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I did some reading on lab services today for Medicare, and it appears that there may not be any co-insurance/deductible with venipuncture. So Medicare pays the allowable, and that is that. This would indicate that a patient would not have a balance, if the claim processes correctly. This MAY be why the facility is saying what they are saying.
One thing to consider, which may or may not apply, is if a patient is under a consolidated billing situation. If that is the case, the facility may have to pay the allowed amount, and not Medicare Part B.
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I think the fact that they have been through several mobile phlebotomist charges is worth looking into.. JMHO :o
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I agree with that, Linda. Something seems "hinky" about that, and in the past, I have found that it is because the facility or whoever is wanting the something done that isn't on the up and up.
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