Author Topic: Are we allowed to charge a patient for extra services?  (Read 2132 times)

Alice Scott

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Are we allowed to charge a patient for extra services?
« on: March 01, 2008, 07:16:24 PM »
Questopm
Hi Ladies I just recently found your sight and love it!!!! I work in a NY
state chiropractors office and we have a question about billing for
"extras". When we use stim. or traction or even the intersegmental traction
on a patient we normally don't charge the patient. There are a few
insurances that due allow us to charge and we do. My question is this, if a
patient has an insurance that doesn't cover such services and we are
considered a participating provider are will allowed to charge the patient
for the services? Do we have to bill the carrier the charges and be denied?
Can we charge a lesser cash amount than what the carriers pay that cover it?


Answer

   I'm glad you like our website.  That's what we have it for.  Whether you can charge the patient or not will vary by insurance plan.  If the insurance has a global allowance and your contract states that is all you are allowed to bill the patient, then you can't bill for extras.  If the plan just doesn't allow for the extras, but there isn't a global fee then you can bill the patient.  The eob will usually indicate the amount you are allowed to bill the patient. 

   Legally you are not allowed to charge an insurance company one fee, and the patient a different fee for the same service.  There are some loop holes around this.  You can have a sliding scale for cash patients and make the level so high that all patients fall under it. 
Hope this info is helpful.
Michele
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