Medical Billing Forum

Billing => Billing => Topic started by: advance11 on June 03, 2009, 08:10:32 AM

Title: Non Participatin
Post by: advance11 on June 03, 2009, 08:10:32 AM
Hi again.  Several question:

1.  Is there a single reference source for billing Chiro?  A book that I can refer to or online classes to take?
2.  We have no contracts with any insurance companies.  Therefore, we can bill the balance to the patient, correct?  Or, can we only bill the patient  if we mark on the 1500 that we do not accept assignment?  (I am trying to reconcile some questions and answers from a few pages back.)
3.  Medicare Replacement Policies--we do not accept assignment, but we chargel Medicare allowable amounts.  Can we balance bill?
4.  Medicare Replacement Policies--do we have to have the patient complete an ABN?
5.  Medicare Replacement Polices that have a copay higher than the charged amount--do we need to have the patient sign anything so that we don't have to bill the policy, but can just private bill the patient for the Medicare Charged amounts?

Thank you in advance...
Title: Re: Non Participatin
Post by: Michele on June 03, 2009, 10:06:16 PM

1.  We have a book on billing chiro.  You can view information on it at
I'm not familiar with any other resources.

2.   If you do not participate then you can balance bill the patient.  But if you check that you accept assignment that is basically saying you agree to their fees for that claim.

3.  If you are non par with Medicare you can charge the patient up to the Medicare limiting charge amount.

4.  I am not sure, but I would recommend it.

5.  Again, I am not 100% sure on this one.  It is a good question.  I'm hoping someone else on the forum can help us out.