Medical Billing Forum
General Category => General Questions => : mforgione August 02, 2012, 12:27:35 AM
-
Question: My clients (client 1) bill to insurance a set fee schedule. They charge their patients who do not have insurance or who have insurance for which they do not par with the same rate...however, since it is the same price (self pay and insurance rate)it seems legit to me...I have another client who bills out services to the insurance company at one rate which is coded appropriately and for self pay patients she states ie, 99205 is 275-she calls this a new patient visit and a 99214 is 150 and she calls this a follow up.
If she makes the financial hardship income $250,000 can she (second client I mentioned) do a sliding scale for patients? Does she have to have this policy written up in a handbook? The second client stated that she felt she can charge cash patients whatever she wanted. I read some other posts in the forum and am slightly confused now.
Please advise
-
Financial policies should absolutely be written up and strictly adhered to. There should be a set rate for patient pay and a policy for hardship. It should NOT be different rates for different people.
Patient's do get frustrated when they change insurance and their portion changes. Blue Cross pays much less to contracted providers than Blue Shield does. So if the patient has a high deductible, they end up paying a lot more out of pocket and they want to know why. It's a hard discussion. It's easier, though, when they present their card and you tell them right up front what they can expect to pay out of pocket. Then there's no surprises.
-
Do I understand correctly that it is ok to charge self-pay patients a certain amount that is lower/different than that charged an insurance?
-
You can have a cash discount. You should still enter the SAME charges as your insurance fee schedule (which should be them same rate you charge ALL insurance other than worker's comp), then have a line item showing the cash discount.
-
Thank you! :)
-
Thank you soooo much!
-
Huh?
-
Huh?
If she creates the economical problems earnings $250,000 can she (second customer I mentioned) do a moving range for patients? Does she have to have this plan published up in a handbook? The second customer described that she sensed she can cost money sufferers whatever she desired. I study some other content in the community and am a little bit puzzled now.
Double HUH???
-
I know its Monday, but I have read all the posts for this, and I guess my reply is:
TRIPLE HUH????
-
Seems like something is being lost in the translation! So I see your Huh? and raise you!
-
Glad to see I'm not losing my mind. I almost deleted it but thought "maybe I'm missing something??"
-
You just posted the same thing that none of us understood above. So once again, HUH?
-
Since John Smith can't spell John correctly, I think we're being scammed. "Varicose veins phoenix" ???
-
He is wasting our time. None of this is understandable. Michelle, I vote to remove his posts.
-
All in favor say "HUH" :)
-
All in favor say "HUH" :)
"HUH"
-
Are you asking if she has to publish a sliding-fee schedule in a handbook? Also, is she saying she can charge her patients that have a financial hardship, anything she wants?
-
HUH, wow lol.
-
I did a little research on him and decided to delete all his posts. I do believe it was spam. It was on topic, but rambling and didn't make sense. :)
-
Getting pack to the OP for a second...How can your client say that she can bill every new patient a 99205 and every follow up a 99214? That alone seems strange to me :P With new patients you have to have 3/3 elements to bill, so in my experience, they are usually actually coded lesser than they would be for an established patient.
-
Does your client have any fee schedules from the insurance carriers that they bill from?