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RE: [MedicalBillers] Re: BCBS FL Fee Schedule

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  • Lin
    So patients are being given a discount routinely without financial hardship arrangements in the file? In your situation there might be some leadway from this
    Message 1 of 25 , Dec 13, 2007
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      So patients are being given a discount routinely without financial hardship
      arrangements in the file?

      In your situation there might be some leadway from this being fraud if the
      patients were under the doctors care prior to him being dropped, in that
      instance the doctor could set forth in writing denouncing his participation
      and letting patients know their out-of-pocket by a certain time frame.
      Usually BCBS has like a 90 day period after they drop someone though, so I
      wouldnÂ’t go beyond that 90 days.





      Linda Walker

      Practice Managers Resource & Networking Community
      <http://www.billerswebsite.com> http://www.billerswebsite.com
      A division of K&L Media, LLC
      <http://www.klmediallc.com> http://www.klmediallc.com

      Website Design & Management for the Medical Services Industry





      From: MedicalBillers@yahoogroups.com [mailto:MedicalBillers@yahoogroups.com]
      On Behalf Of Sarah1230836@...
      Sent: Thursday, December 13, 2007 10:43 PM
      To: MedicalBillers@yahoogroups.com
      Subject: RE: [MedicalBillers] Re: BCBS FL Fee Schedule



      One of the practices that I work with has a similar arrangement with BCBS of
      Florida patients. The physician was dropped by BCBS and has been
      unsuccessful in being added back into the network. I require the patient to
      bring in or fax the EOB before I do any adjustments. If the patient does not
      provide the EOB, then the patient is responsible for the standard fee.

      Sarah Nachimson, CPC

      "djgeisel" <djgeisel@... <mailto:djgeisel%40charter.net> > wrote:

      >You could wait for the EOB or 835 and post from that only the amount
      >paid to the patient, but if you are not par maybe you don't even get
      >an EOB? Many carriers post thier fee schedule on the web site and
      >the out of network coverage is based on the fee schedule at a lesser
      >amount than in network...I think. We are in network (not with Fla)
      >but I used to work for a doc who was out of network and I think that
      >is how it worked. If you know of a provider who is in network maybe
      >you can get the fee schedule from them? Diana
      >
      >--- In MedicalBillers@yahoogroups.com
      <mailto:MedicalBillers%40yahoogroups.com> , Joktan Edison <ejoktan@...>
      >wrote:
      >>
      >> Where do you I find them or else I have to request one
      >> from the BCBS FL??? Moreover, my doctor is not
      >> contracted with BCBS FL and most of the payment goes
      >> to the patient? I want to bill the patient for the non
      >> contracted rates rather than billing the patient the
      >> entire amount. Hope you understand
      >>
      >>
      >> --- djgeisel <djgeisel@...> wrote:
      >>
      >> > Yes they all have a fe schedule! Diana
      >> > --- In MedicalBillers@yahoogroups.com
      <mailto:MedicalBillers%40yahoogroups.com> , Joktan Edison
      >> > <ejoktan@>
      >> > wrote:
      >> > >
      >> > > Lin, Thanks for your reply. I did go through this
      >> > form
      >> > > earlier this morning, however Im wanting to know
      >> > > whether BCBS FL insurance has any standard fee
      >> > > schedule like Medicare has?
      >> > >
      >> > > Joktan
      >> > >
      >> > >
      >> > > --- Lin <italiandoll1967@> wrote:
      >> > >
      >> > > > You can't get a full fee schedule unless your
      >> > > > provider participates and in
      >> > > > their packet should be a fee schedule. You can
      >> > also
      >> > > > send the attached via
      >> > > > fax with specific codes to determine fee
      >> > schedule
      >> > > > allowances.
      >> > > >
      >> > > >
      >> > > >
      >> > > >
      >> > >
      >> >
      >>
      >http://www.bcbsfl.com/es/DocumentLibrary/Providers/FeeScheduleRequestF
      >> > orm.pd
      >> > > > f
      >> > > >
      >> > > >
      >> > > >
      >> > > >
      >> > > >
      >> > > > Linda Walker
      >> > > >
      >> > > > Practice Managers Resource & Networking
      >> > Community
      >> > > > <http://www.billerswebsite.com>
      >> > > > http://www.billerswebsite.com
      >> > > > A division of K&L Media, LLC
      >> > > > <http://www.klmediallc.com>
      >> > > > http://www.klmediallc.com
      >> > > >
      >> > > > Website Design & Management for the Medical
      >> > Services
      >> > > > Industry
      >> > > >
      >> > > >
      >> > > >
      >> > > >
      >> > > >
      >> > > > From: MedicalBillers@yahoogroups.com
      <mailto:MedicalBillers%40yahoogroups.com>
      >> > > > [mailto:MedicalBillers@yahoogroups.com
      <mailto:MedicalBillers%40yahoogroups.com> ]
      >> > > > On Behalf Of debbie brosnan
      >> > > > Sent: Wednesday, December 05, 2007 3:29 PM
      >> > > > To: MedicalBillers@yahoogroups.com
      <mailto:MedicalBillers%40yahoogroups.com>
      >> > > > Subject: Re: [MedicalBillers] BCBS FL Fee
      >> > Schedule
      >> > > >
      >> > > >
      >> > > >
      >> > > > Tell us whats up??? Joktan I havent forgotten
      >> > you
      >> > > > about the appeals letter.
      >> > > > Having problems putting my hands on one. I have
      >> > > > letters for just about
      >> > > > everything but timely filing.
      >> > > >
      >> > > > Joktan Edison <ejoktan@
      >> > > > <mailto:ejoktan%40yahoo.com> > wrote: Could
      >> > > > anyone help me on BCBS FL Fee Schedule. I would
      >> > > > appreciate your help!!!!
      >> > > >
      >> > > >
      >> > >
      >> >
      >> __________________________________________________________
      >> > > > Never miss a thing. Make Yahoo your home page.
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      >> > > > [Non-text portions of this message have been
      >> > > > removed]
      >> > > >
      >> > > >
      >> > >
      >> > >
      >> > >
      >> > >
      >> >
      >>
      >__________________________________________________________
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