Click here for more sample CPC practice exam questions with Full Rationale Answers

Practice Exam

Click here for more sample CPC practice exam questions and answers with full rationale

Practice Exam

CPC Practice Exam and Study Guide Package

Practice Exam

What makes a good CPC Practice Exam? Questions and Answers with Full Rationale

CPC Exam Review Video

Laureen shows you her proprietary “Bubbling and Highlighting Technique”

Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page

Practice Exam

2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

Practice Exam

Click here for more sample CPC practice exam questions and answers with full rationale

Excluded services and discounts

Looking for some guidance on this scenario:

We bill $ 528.00 on a certain procedure code to every insurance company (commercial or Medicare). Based on our individual agreement with those insurances, we write off the difference to get down to our contracted amount (when it is a covered service). However, there are some commercial companies that consider the procedure investigational and/or not a covered benefit, and deem it "non-covered" and patient responsibility.

Can we offer a discounted price to those patients whose insurance does not cover that procedure, as long as the discounted price is the same for un-insured patients?

My physician has concerns about us having "different fee schedules", however the way I see it, we have *one* fee schedule ($ 528.00 billed to all carriers), and we simply offer our own discount when it is non covered, rather than the contracted amount (or making the patient pay the entire amount).

I have tried looking for this on the OIG website, but so far all I have been able to find is reference to un-insured patients.

Any thoughts are appreciated, as well as any links to specific sites (including the OIG).

Medical Billing and Coding Forum

Discounts

I currently work for a lab, we are providing uninsured patients a discounted rate. However, we are a new and upcoming lab, so we are not in-network with many insurance. Therefore, we provide another discount for people with insurance but we are out of network with their plans. Is that appropriate to provide two different discounts, or should we provide the same discount for everyone?

any references you can provide for this information would be great as well!

Thank you!

Medical Billing and Coding Forum

Questionable discounts

Hi, we get a myriad of patients calling asking for discounts on bills that their insurances have applied to their deductible. So we tell them that per our contract with the insurance we are legally obligated to collect the amount specified. We often hear, oh dr. X offered me a 20% discount for paying online. I didn’t really believe this until I happened to get a bill from a provider and was offered a 20% discount for paying through their website. First, that just doesn’t seem right and second, aren’t they getting less money because of credit card fees ?? I’m so confused on how this is legal. Anyone have any insight? These are not cash patients.

Medical Billing and Coding Forum

Multiple Procedure discounts, apply to fee schedule or discount later?

Good Afternoon,

Was wondering if anyone applies multiple procedure discounts to their fee schedule or if you just discounted later on?

I would post full charge, with multiple procedure modifier, and then discount after process if applicable.

Was wondering what others thoughts are on this. Thank You!

Medical Billing and Coding Forum

Are Discounts and Waivers Illegal?

A discount is a reduction in the amount of what a patient owes. Usually these are contractual and negotiated between the insurance carrier and the provider. A waiver would be intentionally not perusing your right to collect a deductible or co-payment. Provider offices are seeing larger deductibles and co-payments as carriers are making the patient […]
AAPC Blog