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Percent Billing and OIG

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odastone:
I know this may have been answered before, however to save myself some grief and time, I'm asking again.

My business is in the early stages of adding on clients, it was brought to my attention that the OIG strictly prohibits fee spliting and that percentage billing would be classified as fee spliting. I cannot find any concrete answer to this statement that says no you cannot percentage bill on the OIG website.  If anyone has a specific link to where I may go and find this information that lists the states that will not allow percentage billing , please post so that we all can have a better grasp on this serious side of our business.

Thanks :-\

RichardP:
Go here and type in fee splitting in the upper right-hand corner (search box), then read:

http://www.medicalbillinglive.com/members/index.php

The OIG does not currently prohibit fee splitting as it pertains to billers charging a percentage of monies collected for the doctor.  Some states do prohibit this, tho - the details of which you should find in your search of this site.  New York and I think Florida prohibit doctors from fee-splitting arrangements.  And the fee splitting prohibition is for doctors, not billers.  Linda can give more specifics.

California does not prohibit fee splitting.  See this thread for how the California Business Code reads in this regard:

http://www.medicalbillinglive.com/members/index.php?topic=7131.msg21583#msg21583

odastone:
Richard, thanks for your info. I'm not seeing what you are saying as to info in the site. If you have a specific in mind please post a link. Sorry to be difficult, just getting a little aggravated trying to find an answer.

PMRNC:


--- Quote ---Richard, thanks for your info. I'm not seeing what you are saying as to info in the site. If you have a specific in mind please post a link. Sorry to be difficult, just getting a little aggravated trying to find an answer.
--- End quote ---

What state are you in?

Also.. can you tell me why you want to charge a %? 

RichardP:
Sorry to be difficult, just getting a little aggravated trying to find an answer.

I gave you the answer in my post above.

I cannot find any concrete answer (on the OIG website) to this statement that says no you cannot percentage bill ...

That is because no such language exists.  The only way we know that the OIG does not prohibit doctors from paying billers a percentage of what they collect is the fact that there is no language published by the OIG that says they prohibit such an arrangement.  On the other hand, some states DO prohibit such arrangements:  New York at least, maybe Florida, and maybe one or two others.

If you need an answer fast re. a specific state, contact a health-care attorney for the state you have questions about.

http://lawyers.findlaw.com/lawyer/practice/health-health-care-law

You would do well to search as I suggested in my post above, and read the posts that come up.  This subject has been discussed a bit on this site.

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