Author Topic: Can a counselor see a patient through a clinic and bill through the psychiatrist  (Read 1474 times)

Michele

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Question
Can a counselor see a patient through a clinic and bill through the psychiatrist with his name and number to an insurance company? Also, is it ethical to bill the insurance company with this and give the patient a discount as they require payment at time of visit and then after the insurance starts paying they accept the checks directly and then apply it to the original higher amount that they billed. In other words, if no reimbursement is made from the insurance company to them they would have still charged the patient one rate and the insurance company another.
Shelly

Answer
Hi Shelly,
If a counselor works for a clinic and the work is supervised by a psychiatrist then the services can be billed under the psychiatristís name and insurance numbers. If the clinic participates with the insurance companies then they cannot charge the patient up front, because they agree not to with the insurance company. But if they don't participate then they can charge the patient up front.
The rest of the question gets a little stickier. It is not legal to charge a patient one fee, but charge an insurance company another fee, but there are ways around it. A provider can have a set fee for a service, which is what they bill the insurance companies, and then have a sliding fee schedule for patients without insurance, or with insurance that don't cover either the service or the provider. The limit for the sliding fee schedule can be set at a level that almost all patients fall into. At least that is what we have been advised by a provider rep from one of our local major insurance carriers. In any case, you do need to be careful that you are not breaking any laws, or rules that may get you kicked out of an insurance company.
Good luck,
Michele
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