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RE: [MedicalBillers] Charging for follow ups?

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  • B Burgess
    Remember that a billable service does have to be supported by medical necessity, and there does have to actually be a service.  If the labs are normal, I
    Message 1 of 6 , Jul 17, 2010
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      Remember that a billable service does have to be supported by medical necessity, and there does have to actually be a service.  If the labs are normal, I don't think it would be fair to have the patient make and appointment and pay a copay just to find that out. A nurse can give them that info over the phone.   Obviously, if the results are NOT normal and there is treatment or further testing needed, then yes, it would be appropriate for the doctor to see and charge the patient to discuss the results and the treatment or implications of the results and/or need for other diagnostic workup.
       
      Barbara Burgess, RN, CPC, ACS-EM. PCS

      --- On Sat, 7/17/10, josette thomas <abcmdbiller123_55@...> wrote:


      From: josette thomas <abcmdbiller123_55@...>
      Subject: RE: [MedicalBillers] Charging for follow ups?
      To: "MedicalBillers" <medicalbillers@yahoogroups.com>
      Date: Saturday, July 17, 2010, 10:11 AM



      everytime u come to the office, everytime u see the drs face there is a fee associated with a valid code, if the insurance policy sez everytime you come to the office there is a copay, coinsurance, deductible then so be it



      To: MedicalBillers@yahoogroups.com
      From: halberts1@...
      Date: Sat, 17 Jul 2010 14:36:04 +0000
      Subject: [MedicalBillers] Charging for follow ups?

       



      We have a on going debate in our office on if we can charge for follow ups. Example: Sue comes in for a BP appt and the Dr orders some lab work. Can we charge her a co-pay for her next appt to review the labs??? Also can we charge her insurance company? It was a problem visit that ended up needing labs. Some think it should be covered in the original co-pay because it is a follow up. Can someone offer us some correct insight. I feel like we are loosing money here.

      Thanks
      Christy Halbert




                               
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    • josette thomas
      legal mentality, need not mention medical necessity, wouldnt have it any other way To: MedicalBillers@yahoogroups.com From: granbfly@yahoo.com Date: Sat, 17
      Message 2 of 6 , Jul 17, 2010
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        legal mentality, need not mention medical necessity, wouldnt have it any other way



        To: MedicalBillers@yahoogroups.com
        From: granbfly@...
        Date: Sat, 17 Jul 2010 11:52:15 -0700
        Subject: RE: [MedicalBillers] Charging for follow ups?





        Remember that a billable service does have to be supported by medical necessity, and there does have to actually be a service. If the labs are normal, I don't think it would be fair to have the patient make and appointment and pay a copay just to find that out. A nurse can give them that info over the phone. Obviously, if the results are NOT normal and there is treatment or further testing needed, then yes, it would be appropriate for the doctor to see and charge the patient to discuss the results and the treatment or implications of the results and/or need for other diagnostic workup.

        Barbara Burgess, RN, CPC, ACS-EM. PCS

        --- On Sat, 7/17/10, josette thomas <abcmdbiller123_55@...> wrote:

        From: josette thomas <abcmdbiller123_55@...>
        Subject: RE: [MedicalBillers] Charging for follow ups?
        To: "MedicalBillers" <medicalbillers@yahoogroups.com>
        Date: Saturday, July 17, 2010, 10:11 AM

        everytime u come to the office, everytime u see the drs face there is a fee associated with a valid code, if the insurance policy sez everytime you come to the office there is a copay, coinsurance, deductible then so be it

        To: MedicalBillers@yahoogroups.com
        From: halberts1@...
        Date: Sat, 17 Jul 2010 14:36:04 +0000
        Subject: [MedicalBillers] Charging for follow ups?



        We have a on going debate in our office on if we can charge for follow ups. Example: Sue comes in for a BP appt and the Dr orders some lab work. Can we charge her a co-pay for her next appt to review the labs??? Also can we charge her insurance company? It was a problem visit that ended up needing labs. Some think it should be covered in the original co-pay because it is a follow up. Can someone offer us some correct insight. I feel like we are loosing money here.

        Thanks
        Christy Halbert


        __________________________________________________________
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        _________________________________________________________________
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      • Irene Valenzuela
        I agree with Josette. If you read your contracts with the insurance companies it states that we should charge a copayment for every visit. Wether the patient
        Message 3 of 6 , Jul 19, 2010
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          I agree with Josette. If you read your contracts with the insurance companies it
          states that we should charge a copayment for every visit.

          Wether the patient is there for abnormal results, to change medicine, to deal
          with a reaction or for a new patient or preventive visit .....there is still
          acharge associated with the service.


          This is the system as it stands now. Once Healthcare Reform and the
          Medical Home concept have been adopted, then things may change and it may be
          handle on a PER CASE basis which means...all visits are all inclusive for that
          particular diagnosis. We are far from that point but definately heading that
          way.

           
          Thanks and have a great day!

          Sincerely,

          Irene A. Valenzuela
          LPC Office Manager

          for:

          INTERNAL MEDICINE:
          Mansoor Shah, MD         Khalid Saeed, MD
          Aaron Kern, MD              Olga Ginzburg, MD
          Cherie Garcia, MD           Scott Gordon, MD 


          RHEUMATOLOGY:
          Ivette Stickelmaier, MD
          Olivia C. Gomez, MD

          DERMATOLOGY:
          Michael Castro, MD
          Monina Distor-Castro, RN - Aesthetic Nurse Specialist




          ________________________________
          From: josette thomas <abcmdbiller123_55@...>
          To: MedicalBillers <medicalbillers@yahoogroups.com>
          Sent: Sat, July 17, 2010 6:06:41 PM
          Subject: RE: [MedicalBillers] Charging for follow ups?


          legal mentality, need not mention medical necessity, wouldnt have it any other
          way



          To: MedicalBillers@yahoogroups.com
          From: granbfly@...
          Date: Sat, 17 Jul 2010 11:52:15 -0700
          Subject: RE: [MedicalBillers] Charging for follow ups?

           



          Remember that a billable service does have to be supported by medical necessity,
          and there does have to actually be a service.  If the labs are normal, I don't
          think it would be fair to have the patient make and appointment and pay a copay
          just to find that out. A nurse can give them that info over the phone. 
          Obviously, if the results are NOT normal and there is treatment or further
          testing needed, then yes, it would be appropriate for the doctor to see and
          charge the patient to discuss the results and the treatment or implications of
          the results and/or need for other diagnostic workup.

          Barbara Burgess, RN, CPC, ACS-EM. PCS

          --- On Sat, 7/17/10, josette thomas <abcmdbiller123_55@...> wrote:

          From: josette thomas <abcmdbiller123_55@...>
          Subject: RE: [MedicalBillers] Charging for follow ups?
          To: "MedicalBillers" <medicalbillers@yahoogroups.com>
          Date: Saturday, July 17, 2010, 10:11 AM

          everytime u come to the office, everytime u see the drs face there is a fee
          associated with a valid code, if the insurance policy sez everytime you come to
          the office there is a copay, coinsurance, deductible then so be it


          To: MedicalBillers@yahoogroups.com
          From: halberts1@...
          Date: Sat, 17 Jul 2010 14:36:04 +0000
          Subject: [MedicalBillers] Charging for follow ups?

           

          We have a on going debate in our office on if we can charge for follow ups.
          Example: Sue comes in for a BP appt and the Dr orders some lab work. Can we
          charge her a co-pay for her next appt to review the labs??? Also can we charge
          her insurance company? It was a problem visit that ended up needing labs. Some
          think it should be covered in the original co-pay because it is a follow up. Can
          someone offer us some correct insight. I feel like we are loosing money here.

          Thanks
          Christy Halbert

                                   
          __________________________________________________________
          The New Busy is not the too busy. Combine all your e-mail accounts with Hotmail.
          http://www.windowslive.com/campaign/thenewbusy?tile=multiaccount&ocid=PID28326::T:WLMTAGL:ON:WL:en-US:WM_HMP:042010_4


          [Non-text portions of this message have been removed]

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          [Non-text portions of this message have been removed]




                                 
          _________________________________________________________________
          The New Busy think 9 to 5 is a cute idea. Combine multiple calendars with
          Hotmail.

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        • djgeisel
          I would call the insurance carrier and get the benefits department and ask that question specifically. There are some situations that one copay covers an
          Message 4 of 6 , Jul 21, 2010
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            I would call the insurance carrier and get the benefits department and ask that question specifically. There are some situations that one copay covers an entire episode and there are some that a per visit copay is collected. In our specialty it is either a per visit copay or co-insurance or deductible, but it is charged for every visit/encounter. When you bill the procedure out does the insurance carrier assess a copay for each encounter/visit? Then you should be charging one. If they do not but considier it as still under the same episode like from 07/01/10 to 07/10/10 then you should not be charging one. Ask the carrier.
            Diana of TX

            --- In MedicalBillers@yahoogroups.com, "halberts1" <halberts1@...> wrote:
            >
            > We have a on going debate in our office on if we can charge for follow ups. Example: Sue comes in for a BP appt and the Dr orders some lab work. Can we charge her a co-pay for her next appt to review the labs??? Also can we charge her insurance company? It was a problem visit that ended up needing labs. Some think it should be covered in the original co-pay because it is a follow up. Can someone offer us some correct insight. I feel like we are loosing money here.
            >
            > Thanks
            > Christy Halbert
            >
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