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Billing for Addiction Medicine...

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Michele:
That sounds like a reasonable suggestion.  I'm curious as to why they are going from cash to insurance.  Is the cash not working that great?  Most providers want to go from insurance to cash and not vice versa! 

The only issue with your suggestion is that out of network claims are usually processed completely differently than in network so submitting out of network may not give a good picture of what will happen if in network, but it would give you a picture of what services are allowed.

Minimole:
Thanks!   :)

PMRNC:
Can I throw something out there that might not be relevant to what your asking?

I too have good word of mouth reputation in a few states as I started my billing company with mental health.

They are really scrutinizing the hell out of internal medicine, family practitioners prescribing those meds (methadone, suboxone, etc) HIGHLY regulated industry and not just with regards to billing but other area such as OSHA. SOMETIMES these practices are refusing insurance to stay under the radar. I'm NOT assuming that's case here. It just leaves one scratching their head as to why patients would pay cash for a service their insuranced would most likely HAVE to pay (due to existing and now new mandatory treatment regs)   I have seen from a few angles how this works. Doctor gives out the meds to patient, patient earns their take home, patient sells take home, doctor gets a cut. Sometimes the reason they start doing this is as simple as a town or county ordinance that won't let them distribute or provide those drugs so they do it "cash" and again, stay under the radar.

Again, I am NOT saying this is the case. I am the ultimate pessimist because not only have I seen doctors busted for this but I have known people (patients) do this with their doctors. It's actually bad rampant in some parts of NJ and NY. Since they don't take insurance they fly under radar and using the status of their practice (family, internal med) etc. Often kickbacks are also involved.

My intentions are good I promise. You can disregard, but if it were me I'd have to do a little more research before I took on this type of practice. Proceed with caution.

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