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Topic: Copays (Read 4880 times)
tlovita1@aol.com
Newbie
Posts: 8
Copays
«
on:
February 03, 2011, 01:23:12 PM »
Hi
,
My dr sees the patient for patch testing, and charges a copay, then 3 days later the patient comes back for the results of the patch, should we charge a copay for the f/up visit of that patch?
So the patient is paying, we'll say 50.00 on 1-3-11 , then 3 days later she is paying another 50.00 copay. Should we not collect the copay for that f/up visit?
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rdmoore2003
Hero Member
Posts: 631
Live Life and Love God
Re: Copays
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Reply #1 on:
February 03, 2011, 05:54:17 PM »
If I understand the question, when pt comes back 3 days later, that would be a f/u (follow up) then no you would not.....
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Pay_My_Claims
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Re: Copays
«
Reply #2 on:
February 03, 2011, 06:01:44 PM »
is it a visit or a "no charge" . Its like a TB test, there is a charge to give and a charge to receive. Those are billed as Nurse Visits, so no copay for those. Some physicians do a "no charge" visit. for certain f/u
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tlovita1@aol.com
Newbie
Posts: 8
Re: Copays
«
Reply #3 on:
February 07, 2011, 10:33:10 AM »
The f/up is considered a visit, we charge for it, but the dr wanted to waive the copay for the f/up visit, so should we waive the copay?
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PMRNC
Hero Member
Posts: 4562
Re: Copays
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Reply #4 on:
February 07, 2011, 11:14:44 AM »
If you are billing the insurance, than if you waive the copay you need to let the insurance carrier know as well. you cannot discount the patient w/out discounting the carrier. I don't even know that you bill the carrier for a followup for that?? If a followup was required wouldn't it be included in the original charge/CPT?
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Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
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Medical Billing Forum
Re: Copays
«
Reply #4 on:
February 07, 2011, 11:14:44 AM »
DMK
Hero Member
Posts: 680
Re: Copays
«
Reply #5 on:
February 07, 2011, 02:52:59 PM »
Just chiming in....if the Doctor is charging for an office visit it's my understanding you HAVE to charge the Co-pay. If the visit goes to the patient's deductible, you would have to collect the deductible. A CHARGED for visit is a visit you have to charge for! I would hope that the visit is charged for appropriately too. I can't stand seeing a doctor charge for a detailed visit (99214 or 215) when he spent 2 minutes. The detailed visit would have been the 1st visit (99215), and the follow up should be a minimal (99212). The co-pay is the same for both, but the reimbursement is different, if the visit goes to the patient's deductible the second visit would be less than the first visit.
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rdmoore2003
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Posts: 631
Live Life and Love God
Re: Copays
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Reply #6 on:
February 07, 2011, 06:07:10 PM »
i think it may also depend on the dx code. for instance, my son has blue cross and went to dr for appt was charged like a 99213 we paid his copay. that was done correct. then 2 weeks later we went for a f/u. claim was sent to insurance as 99212 but dx code was a v code used as a f/u visit. per my eob, dr was reimbursed for 99212 but due to dx I was not responsible for copay on f/u visit. this has happened many times with my family and in different dr offices that i have seen. Are the insurance companies doing this wrong?
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DMK
Hero Member
Posts: 680
Re: Copays
«
Reply #7 on:
February 07, 2011, 06:59:47 PM »
That's excellent, and good to know for the future!
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Medical Billing Forum
Re: Copays
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Reply #7 on:
February 07, 2011, 06:59:47 PM »
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Medical Billing Forum
»
General Category
»
General Questions
(Moderators:
Alice Scott
,
Michele
) »
Copays