Author Topic: Charging Copays in Global  (Read 984 times)

DebraS

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Charging Copays in Global
« on: December 04, 2010, 11:32:27 AM »
I read in a previous thread that you should never charge a copay in global. In most parts this is true. However, the actual answer lies in the patients benefits and what services you provide/specialty. For example, I work for an ortho.  Most patients do not have a copay because the copay is attached to their E/M. However, some have copays no matter what charge is billed. For example: patient comes in for a postop visit.  No E/M is charged, however the xray is.  According to the patients benefits, a copay applies since he had an xray. It's all in the benefits and how the benefits questions are asked. We ask for SP benefits, get the copay, coins, etc.. then we ask does a copay apply if the patient gets a diag xray only or a joint injection only?  This way we know up front which ones to collect a copay on and when.  Of course we don't collect these copays until check-out because we don't know if they'll get an xray or not and xrays are not part of the global package.
Debra Sanders

Michele

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Re: Charging Copays in Global
« Reply #1 on: December 06, 2010, 07:55:15 AM »
Sounds like some plans charge a copay for services that are not considered part of the global service.
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