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2 separate FEE schedules for ONE OFFICE

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Angie:
Thank you Linda for all of your help!

Angie:
Linda when I am providing them with a super bill and there are no codes for a service provided how do I put that on an itemized statement for the patient so that they can submit it to their insurance to see what portion the insurance may reimburse them for? (This is all inclusive, private pay and the family is wanting an itemized statement so they can submit it to their insurance to see what portion of the program the insurance may reimburse them)
I know how to list and code the Individual Sessions with the licensed therapist (have notes for those) but for instance the family weekly calls that the therapist provides each week. The therapist calls the family weekly to provide them with a summary of the patients week, family feedback, discussing aftercare, etc.....This is done over the phone and not really a "family therapy session" per say..... There are no codes for this so any advise on how to list it on a superbill?????

PMRNC:
What I think you are trying to do is admirable to help the patient, however your facility does not participate in insurance billing/claims.. With that said, here is what I believe you should do and what I would do. I would give them the same bill that you would give any other patient and let them fight with their insurance companies, it's really out of your hands at this point. If you really think you need to do this then all I can suggest is that you take the time and code things as much as possible and the services with no codes you should itemize and use the 99999 CPT. 

I'm sure since your facility is non insurance, you guys have a policy that patient's see up front?

Angie:
Yes we most defiantly do have a policy in place but you would not believe the amount of requests (demands) that we get for this.... I can provide them with a UB04 but there is no code for "Wilderness Program" and we cannot code it as Residentail Treatment even though they are in our care 24/7 because we don't meet the criteria for RTC; no building with beds, no RN on site 24/7 etc....... If we did provide them with a UB04 would there be an appropriate rev code for Therapeutic Wilderness Program do you think? There is a billing company here locally that I know does some of this and they use the Residential Treatment code even though they are not licensed as such and she insists she can do this because there is no code for Wilderness Programs that she has to use the closest code but that does not seem very ethical to me and seems really misleading to the insurance (even though it will get denied because they don't cover wilderness programs in the end and once they review the records they will see this but she will appeal it, that is what she does).....but I am a bit anal and tend to be more conservative I guess!

PMRNC:
Ok, so what would happen if you refer the patient back to that policy they obviously have seen and signed and tell them you would be happy to give them a copy of the bill and just give them what you would normally give them. Period?   I think you have to draw line because technically your not following your own policies and procedures.   Tell the patient, I'm sorry but this is all we provide, as per the policy to which you seen at the beginning of treatment.   I think you'll be stress free, <G> JMO.   It can't be a surprise to them. If your financial policy doesn't include anything about the patient's bill. Add it in there, put in there that they will receive the offices billing statement as available and that's it.

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