Medical Billing Forum
Billing => Billing => : SIbiller December 24, 2014, 12:51:30 AM
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Hi..I have a Cardiologist in NY who is being asked to send medical records for pretty much all of his claim submissions. They seem to be auditing him. He was inquiring if there is a Medicare billable code for medical records. I know there is a code S9981 but I don't think Medicare pays for that code. Any info would be greatly appreciated.
Thank You.
Erica
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He is being audited. You cannot bill Medicare for copying medical records. They are entitled to everything they ask for ..all at the physician's expense. Yes it is a pain but there has to be something that he is billing that has flagged the account.
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they are claiming that it is random and that it happens sometimes. Sounds strange to me. If it wasn't an audit would they pay for those fees just a general question.thnx
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Agree with Merry...there is nothing you can charge when an insurance company processing the claims requests patient records/treatment notes, etc. It is at the provider's expense. If if was the patient requesting records, or a third party such as in a lawsuit, that would be a different story. But when the patient's insurance company wants the records, you send them, free of charge.
As it would appear, he may be being audited, so he shouldn't delay in sending in what they request. Some of the providers I work for get occasional requests from Medicare for treatment notes, and they are sent in same day as the request arrives.
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If it wasn't an audit would they pay for those fees just a general question.thnx
No, they would not pay, not to my knowledge of any insurance company asking for notes from a contracted provider. It is part of the cost of doing business for the provider...not everything can be charged for.
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They seem to be auditing him.
I think you need to find out FOR sure ..
Agree with the others, you cannot charge for records to Medicare.