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5495RE: [MedicalBillers] Re: 99050 After Hours - Coding Help!

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  • josette sylvan
    Jun 1, 2011
    • 0 Attachment
      NOW WE GOT SOMETHING TO WORK WITH

      YOU PAR SO CHARGE WHAT EVER YOU WANT TO CHARGE BECAUSE PAR DRS ONLY RECIEVE THE ALLOWABLE AMOUNTS FROM THE INSURANCE COMPANY. JUST TRY NOT TO UNDER CHARGE. GOOD LUCK



      To: MedicalBillers@yahoogroups.com
      From: melindadocsmith@...
      Date: Tue, 31 May 2011 16:36:04 +0000
      Subject: [MedicalBillers] Re: 99050 After Hours - Coding Help!






      Premera Blue Cross & Dr. is Par.
      Family Practice
      Patient is eligible for coverage
      Prior auth not needed outpatient services. No PCP is necessarily assigned.

      Thanks for your reply!

      --- In MedicalBillers@yahoogroups.com, josette sylvan <abcmdbiller123_55@...> wrote:
      >
      >
      > Most importantly, you failed to mention if there is any insurance coverage? if its not cash............
      >
      > do you par with the insurance
      > what is the drs specialty
      > is the patient eligible
      > would the service need authorization????????
      >
      > the coding is good as far as i can see, office usually makes up their own fee schedule for services, it is usually derived from what it cost you to provide the service plus 10% for profit.
      >
      > Not the case if it is an insurance plan situation, again if the dr par or dont par is the question? you may not get paid at all! good luck
      >
      >
      > To: MedicalBillers@yahoogroups.com
      > From: melindadocsmith@...
      > Date: Fri, 27 May 2011 21:50:29 +0000
      > Subject: [MedicalBillers] 99050 After Hours - Coding Help!
      >
      >
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      >
      > One of our patients called, after the office was closed for the Memorial Day weekend, and requested to bring a young 1 yr old boy in to be looked at for possible stitches. Our patient runs a day care and it was one of her day care children - not her own. This mom is notorious for paging him after hours, when he is not on-call. Dr. said he'd see the boy. They arrived approx. 12:45pm.
      >
      > Apparently, after the patient was here, we discovered that the child's regular family practice would not suture a 1 yr old & neither would the urgent care clinic. We are billing 12011 as the cheek needed suturing.
      >
      > Would you also bill the 99050? What would be your fee amt?
      > 99050 = Services provided in the office at times other than the regularly scheduled office hours, or days when the office is normally closed (e.g. holiday, saturday, or sunday), in addition to the basic service. Our office is normally open Mon, Tues, Thurs & Fri 8-5 and Wed 8-12. We close for lunch from 12:1:30pm daily.
      >
      > Would you add a modifier 25 on the 99050?
      >
      > Your help is appreciated!
      >
      > Melinda Brown, CMBS
      > Ins Biller
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      > [Non-text portions of this message have been removed]
      >





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