Medical Billing Forum
Payments => Patient Billing => : shellabell32 June 22, 2010, 08:02:16 PM
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My manager consulted a "billing expert" that told her we can charge our patient's their copay during a global period. We are not doing any procedures and are not not billing the CPT 99024 to the insurance company. Some of our patient's have protested and most calls to the insurance companies we are told not to charge. I wondered if anyone has any knowledge of policy or if it is a case by case depending upon insurance policy?
Thanks,
Michelle
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how can you bill a copay for a non billable service??? Its global. all visits are covered under one charge, one copay.
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Ditto to Charlene's question, that's why it's a global fee!
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That's what we in the billing department said. However, they are still having us collect the money. I have no idea who this "expert" is, but I was pretty sure the info was incorrect. We are basically adding a charge into the system in the amount of the copay to post the payment to.
Thanks!!
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The sad part is the "expert" got paid a ton I'm sure. I agree with Charlene & Linda, they are wrong. And if the insurance carrier gets wind of it the provider will get booted from the plan.
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Ditto with the rest of the team. The only way that a copay can be collected is if the pt is presenting for a visit non related to the global package. I smell some trouble here and if your expert is advising charging copays on global packages then my advice is to drop the ex'PERT' and make this consultant an 'EX'pert"
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I agree with everyone. If he doesn't want to listen then show him the hard proof that. I would go to that insurer's website and get the guidelines on global period or get a copy of the member's handbook to show your provider.
Example from BCBS
http://notesnet.carefirst.com/ecommerce/medicalpolicy.nsf/vwwebtablex/947a0092d19590c7852576930056c4e5?OpenDocument
Or Coventry Health Plan - This is their Georiga plan (page 18)
http://chcgeorgia.coventryhealthcare.com/web/groups/public/documents/webcontent/c042241.pdf
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Thanks for the references!
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