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Medical Billing Forum
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Payments
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Patient Billing
(Moderators:
Alice Scott
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Michele
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Charging co-pays during global
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Topic: Charging co-pays during global (Read 26043 times)
shellabell32
Newbie
Posts: 5
Charging co-pays during global
«
on:
June 22, 2010, 08:02:16 PM »
My manager consulted a "billing expert" that told her we can charge our patient's their copay during a global period. We are not doing any procedures and are not not billing the CPT 99024 to the insurance company. Some of our patient's have protested and most calls to the insurance companies we are told not to charge. I wondered if anyone has any knowledge of policy or if it is a case by case depending upon insurance policy?
Thanks,
Michelle
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Pay_My_Claims
Guest
Re: Charging co-pays during global
«
Reply #1 on:
June 22, 2010, 09:38:59 PM »
how can you bill a copay for a non billable service??? Its global. all visits are covered under one charge, one copay.
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PMRNC
Hero Member
Posts: 4562
Re: Charging co-pays during global
«
Reply #2 on:
June 22, 2010, 10:42:59 PM »
Ditto to Charlene's question, that's why it's a global fee!
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Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com
shellabell32
Newbie
Posts: 5
Re: Charging co-pays during global
«
Reply #3 on:
June 22, 2010, 10:49:52 PM »
That's what we in the billing department said. However, they are still having us collect the money. I have no idea who this "expert" is, but I was pretty sure the info was incorrect. We are basically adding a charge into the system in the amount of the copay to post the payment to.
Thanks!!
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Michele
Administrator
Hero Member
Posts: 5927
Re: Charging co-pays during global
«
Reply #4 on:
June 23, 2010, 11:50:15 PM »
The sad part is the "expert" got paid a ton I'm sure. I agree with Charlene & Linda, they are wrong. And if the insurance carrier gets wind of it the provider will get booted from the plan.
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Medical Billing Forum
Re: Charging co-pays during global
«
Reply #4 on:
June 23, 2010, 11:50:15 PM »
oneround
Full Member
Posts: 226
Re: Charging co-pays during global
«
Reply #5 on:
June 25, 2010, 01:38:58 PM »
Ditto with the rest of the team. The only way that a copay can be collected is if the pt is presenting for a visit non related to the global package. I smell some trouble here and if your expert is advising charging copays on global packages then my advice is to drop the ex'PERT' and make this consultant an 'EX'pert"
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Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare
blhoffman
Full Member
Posts: 112
Re: Charging co-pays during global
«
Reply #6 on:
June 28, 2010, 05:12:36 PM »
I agree with everyone. If he doesn't want to listen then show him the hard proof that. I would go to that insurer's website and get the guidelines on global period or get a copy of the member's handbook to show your provider.
Example from BCBS
http://notesnet.carefirst.com/ecommerce/medicalpolicy.nsf/vwwebtablex/947a0092d19590c7852576930056c4e5?OpenDocument
Or Coventry Health Plan - This is their Georiga plan (page 18)
http://chcgeorgia.coventryhealthcare.com/web/groups/public/documents/webcontent/c042241.pdf
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shellabell32
Newbie
Posts: 5
Re: Charging co-pays during global
«
Reply #7 on:
June 30, 2010, 12:56:26 PM »
Thanks for the references!
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Re: Charging co-pays during global
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Medical Billing Forum
Re: Charging co-pays during global
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Charging co-pays during global