Medical Billing Forum

General Category => General Questions => Topic started by: jguthriestoneburner on May 14, 2015, 12:52:08 AM

Title: Stark Law violation?
Post by: jguthriestoneburner on May 14, 2015, 12:52:08 AM
Good Evening,

I work in a multidisciplinary clinic which provides DC, ND, LMP, PT and ND PCP. If a provider's child is seen in the clinic with the PCP and bloodwork is ordered to an external lab is there any part of the visit that can be billed to insurance? The Provider is not the owner and there seems to be a general consensus that the in-house services can be complimentary and the labwork be billed to insurance, however my gut is screaming "NO" due to Stark Law. Am I wrong? Can anyone help me clarify this?
Title: Re: Stark Law violation?
Post by: Rclausing on May 15, 2015, 11:57:07 AM
Certainly the physician is precluded from billing for services rendered to a relative, but as long as there is no financial relationship between the physician and the lab, I can't think of a reason why lab services cannot be billed normally. Here's a good question: If the lab services are billed to insurance and there is a coinsurance amount, will the physician (responsible party) be billed? If so, I would have to think Stark would not play into this scenario. I am, of course, not an attorney.