Medical Billing Forum

Billing => Billing => Topic started by: Alice Scott on March 31, 2008, 04:32:26 PM

Title: Do any insurance companies that reimburse physicians for telephone calls?
Post by: Alice Scott on March 31, 2008, 04:32:26 PM
Question
Do you know of any commercial insurance companies that actually reimburse physicians for telephone calls? 99371-99373? And if so, which one’s?
Bridget

Answer
Hi Bridget,

   I am not aware of any specific insurance carriers that do allow for telephone calls.  The few that I have billed were not allowed.  Each plan and company goes by their own guidelines.

Sorry I couldn’t be of more help.

Michele
Title: Re: Do any insurance companies that reimburse physicians for telephone calls?
Post by: jns85008 on August 22, 2008, 05:10:52 AM
This is something that a lot of docs are wanting to know. We have received info from Aetna and United Healthcare stating that they will reimburse for phone calls, but the guidelines are very strict. We can bill out any cpt code in the book, however, that does not mean the ins company will pay for it. Even though insurance companies are including these codes in their fee schedules does not mean reimbursment for your providers. More than likely if you bill for these codes they are going to get denied for not being a covered benefit. So like any cpt code, these codes are billable, but are more than likely not a part of your pt's benefit plan. The reimbursment for these codes range anywhere from $11 - $35 depending on the code billed. Since it comes back as not a covered benefit, it would be up to the provider if he/she wanted to bill the pt and technically they could, but I think if we all started billing pt's for phone calls they would be highly upset. Recently, I attended a great Medicare/OIG seminar. Many dr's were there and this was a big topic of discussion. One particular example that I thought was quite interesting was a surgeon that brought up the fact that she spends a lot of time on the phone with pt's, ins companies and hospitals coordinating pt's care. For instance, dr sends the pt for a ct scan, the scan comes back abnormal and it's an urgent situation, however, it's the weekend, the dr can not see the pt until the following week in the office. She gets the call from the radiologist, calls the pt, spends about 30 min explaining the results and the plan of action for care. She then coordinates an additional test that the radiologist recommends to be done at the hospital, calls the pt back gives the info re the additional test to be performed. Instructs the pt to follow up first thing Monday morning at the office. We were told by medicare as long as all of the phone calls are properly documented in the chart, those phone calls can be referenced during the follow up visit at the office on that Monday and the e/m code can be increased. I found this very interesting. I have a couple of dr's that now do this. I have one provider that makes all his pt's come in for every little thing. No more refills or referrals over the phone. If the patients have a request from the dr, they must be scheduled. With the continuous cuts in reimbursement, this is a must for smaller practices to keep their doors open. I hope this helps.