Author Topic: Is is double billing?  (Read 2805 times)

all5ofus

  • Newbie
  • *
  • Posts: 1
Is is double billing?
« on: August 11, 2011, 12:07:30 AM »
I have previously had many procedures at a Pain Center where there are 3 different companies. One is the doctor, another is the anesthesia and the last is the day surgery center. I have been going thorugh my bills and notice that on many occasions I was charged the same code on both the doctor bill and the surgery center bill for the same day. There are several codes that are duplicated such as 62311 and 72275 although one 72275 ends in 26 the other in TC. On another day the duplicate codes are 64622, 64623 and 72100 TC. The insurance company paid without question. Were they possible splitting the costs or did they get away with charging double?

Michele

  • Administrator
  • Hero Member
  • *****
  • Posts: 5927
    • Solutions Medical Billing
Re: Is is double billing?
« Reply #1 on: August 11, 2011, 11:13:32 AM »
The TC is the technical component, or the facility charge.  The 26 is the professional component or the physician's charge.  It is common for them to be billed separately.  The TC & 26 tell the insurance carrier that they are only billing for their part of the code.
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

ascbillingspecialist

  • Newbie
  • *
  • Posts: 1
Re: Is is double billing?
« Reply #2 on: October 02, 2011, 09:26:46 PM »
It is not uncommon to receive three separate bills for any one surgical service. As you mentioned you will have the physician, facility(surgery center), and anesthesiologist.  They are typically three separate entities and they provide for different services during the procedure.  The same codes are used because they are describing the same procedure in this case the injection codes do not vary between the surgeon and the facility, but the anesthesia code should have been different.  At times anesthesia services are is billed as part of the facility fee, but that will depend on the type of anesthesia provided and the relationship between the provider and the facility. 

Michele

  • Administrator
  • Hero Member
  • *****
  • Posts: 5927
    • Solutions Medical Billing
Re: Is is double billing?
« Reply #3 on: October 03, 2011, 10:25:07 AM »
And don't forget sometimes the assistant surgeon bills separately as well.   :D
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

Medical Billing Forum

Re: Is is double billing?
« Reply #3 on: October 03, 2011, 10:25:07 AM »