General Category > General Questions
Billing Services
Michele:
Type of bill 0842 probably would be fine, because as we've been stating all along, it probably won't be reimbursed. I wouldn't change it to outpatient even when billing the therapy sessions. The patient was inpatient when the sessions took place. As for the rev code for room and board, I would use the regular room & board rev codes, whether is is private, semi-private etc. The room & board is room & board. The type of bill indicates where the room & board is, and the facility name as well.
As for the book, I'd have to put it in line......we have so many projects we are trying to get to!
PMRNC:
--- Quote ---My question is it legal for that company to take our superbill and prepare it onto a UB04 or 1500 without our knowledge and submit it to the insurance company?
--- End quote ---
No, it's not illegal at all. In fact many Union's and other self-funded policies still require the patient to submit the claim form. My plan up until just last year gave me forms to complete and submit. Also there are still companies providing CAP services for patient's and they need only obtain the proper forms for patient consent.. as for record's your only obligated to release them to the patient and I wouldn't do anything for anyone but the patient and then let them go from there (self-disclosure) My dental plan still requires me to send in the stupid handwritten form so I give it to my dentist. Many self-funded plans have not caught up to the times due to cost restraints.
Another thing I'm wondering is that could it be an A/R Factoring company? I had a provider one time go out to dinner with some guy and next thing I know the guy is contacting me for the AR because the doctor signed the A/R over.. without even looking into all the ramifications and consequences.. I bowed out of that client fast because he was planning on retirement and I knew this was going to cause a lot of headaches when patient's called about bills they knew nothing about! He didn't even tell me until AFTER the fact and expected me to just turn over the A/R!
Angie:
Linda has your company ever done any billing for a therapeutic wilderness program or I should say have you had an experience with it? If so I would LOVE some advise!
And I agree with a comment on another topic posted today; with you and Michele's combine 50 years experience! This forum has been a breath of fresh air and I am so grateful for all of your knowledge you ladies are willing share! Just to put that out there ;)
PMRNC:
--- Quote ---Linda has your company ever done any billing for a therapeutic wilderness program or I should say have you had an experience with it? If so I would LOVE some advise!
--- End quote ---
No actually I am a bit flushed to ask..but what kind of therapy is that? I had a provider who specialized in pet therapy and that was different but very straight forward since the carriers did not cover it.
Angie:
Sorry I was not more clear.....
The students (ages 12-17) live in the wilderness for 6-8 weeks with the field staff (who are not licensed therapists) and our licensed therapist (LCSW, Psychologist, Ph.D., ect) go to the field 2 days a week and provide individual (face to face) therapy sessions and group therapy sessions, hand out therapeutic assignments for the week ect… also they do a family therapy session over the phone weekly . It is kind of like Residential Treatment but in the wilderness (without four walls). The diagnosis of the students are typically dealing with Major Depression, Oppositional Defiance, ADHD, PTSD ect..more of a mental health diagnosis. Typically after our program they go to Residential Treatment for a more long term care.
I hope that helps....
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