Medical Billing Forum

General Category => General Questions => Topic started by: patr on January 24, 2012, 12:59:53 PM

Title: Basic question about charges
Post by: patr on January 24, 2012, 12:59:53 PM
Hi all,

I'm not an medical biller but rather an academic researcher working with billing data. I have a simple question I was hoping you might be able to help me with. I have some charge information extracted from UB-92 and UB-04 forms. I've noticed that many of the charge entries are for $0.00. My question is why this occurs - why does a facility often submit a claim of zero dollars to the payer?

Apologies if this is obvious, but as an outsider I haven't been able to find an explanation yet.

Thanks!
Title: Re: Basic question about charges
Post by: PMRNC on January 25, 2012, 08:17:47 AM
Audit and inventory purposes.
Title: Re: Basic question about charges
Post by: DMK on January 25, 2012, 10:31:19 AM
Just out of curiosity, would you also bill this way if your facility provides an "all inclusive" program?
Title: Re: Basic question about charges
Post by: PMRNC on January 25, 2012, 12:18:31 PM
Just out of curiosity, would you also bill this way if your facility provides an "all inclusive" program?

I guess it would depend on a lot of things.. would coding and claims require services to be broken out, things like that would have to be considered. For most part due to compliance issues, and audit trail requirements, I always say it's best to itemize as much as possible.
Title: Re: Basic question about charges
Post by: Angie on January 25, 2012, 01:57:58 PM
Linda so you would suggest breaking out/itemizing say therapy sessions that were provided within the all inclusive rate with the correct coding?
Example:
Rate for RTC is $450.00 a day. Insurance will not cover RTC and facility is OON; would you break out the therapy sessions being provided directly by the therapist; like:
1/1/12  Individual Therapy  90818 $50.00
and provide this to the patient if they want to try to seek reimbursement? Policy is in place that it is private pay and payment is collected upfront.
Title: Re: Basic question about charges
Post by: Angie on January 27, 2012, 08:50:22 AM
Does anyone have any advice on my last post?
Title: Re: Basic question about charges
Post by: PMRNC on January 28, 2012, 10:07:32 AM
I would stick with your own financial policy. If your rates are inclusive, they are inclusive. Unless you uniformly break out all charges than stick with what you are doing. If you are going to break it out for one, then it might be in best interest of the practice to have all bills itemized and broken down. JMO