Medical Billing Forum

Payments => Patient Billing => Topic started by: shellabell32 on June 22, 2010, 05:02:16 PM

Title: Charging co-pays during global
Post by: shellabell32 on June 22, 2010, 05:02:16 PM
My manager consulted a "billing expert" that told her we can charge our patient's their copay during a global period. We are not doing any procedures and are not not billing the CPT 99024 to the insurance company. Some of our patient's have protested and most calls to the insurance companies we are told not to charge. I wondered if anyone has any knowledge of policy or if it is a case by case depending upon insurance policy?

Thanks,
Michelle
Title: Re: Charging co-pays during global
Post by: Pay_My_Claims on June 22, 2010, 06:38:59 PM
how can you bill a copay for a non billable service??? Its global. all visits are covered under one charge, one copay.
Title: Re: Charging co-pays during global
Post by: PMRNC on June 22, 2010, 07:42:59 PM
Ditto to Charlene's question, that's why it's a global fee!
Title: Re: Charging co-pays during global
Post by: shellabell32 on June 22, 2010, 07:49:52 PM
That's what we in the billing department said. However, they are still having us collect the money. I have no idea who this "expert" is, but I was pretty sure the info was incorrect. We are basically adding a charge into the system in the amount of the copay to post the payment to.

Thanks!!
Title: Re: Charging co-pays during global
Post by: Michele on June 23, 2010, 08:50:15 PM
The sad part is the "expert" got paid a ton I'm sure.  I agree with Charlene & Linda, they are wrong.  And if the insurance carrier gets wind of it the provider will get booted from the plan.
Title: Re: Charging co-pays during global
Post by: oneround on June 25, 2010, 10:38:58 AM
Ditto with the rest of the team.  The only way that a copay can be collected is if the pt is presenting for a visit non related to the global package.  I smell some trouble here and if your expert is advising charging copays on global packages then my advice is to drop the ex'PERT' and make this consultant an 'EX'pert"
Title: Re: Charging co-pays during global
Post by: blhoffman on June 28, 2010, 02:12:36 PM
I agree with everyone. If he doesn't want to listen then show him the hard proof that. I would go to that insurer's website and get the guidelines on global period or get a copy of the member's handbook to show your provider.

Example from BCBS
http://notesnet.carefirst.com/ecommerce/medicalpolicy.nsf/vwwebtablex/947a0092d19590c7852576930056c4e5?OpenDocument

Or Coventry Health Plan - This is their Georiga plan  (page 18)
http://chcgeorgia.coventryhealthcare.com/web/groups/public/documents/webcontent/c042241.pdf
Title: Re: Charging co-pays during global
Post by: shellabell32 on June 30, 2010, 09:56:26 AM
Thanks for the references!