I’m a little confused on which way to go with this one. At first I was thinking that I would bill for the body scan with the 52 modifier but now I’m thinking that I would only bill for the injection.
Can anyone help break this down for me?
Thanks
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Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page 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 Click here for more sample CPC practice exam questions and answers with full rationaleI’m a little confused on which way to go with this one. At first I was thinking that I would bill for the body scan with the 52 modifier but now I’m thinking that I would only bill for the injection.
Can anyone help break this down for me?
Thanks
Patient’s response to my invoice is that copays should be $ 12 per visit and not $ 30. My response: According to insurance company, cost-share was increased 1/1/18 he should have received documentation with his plan updates. Invoice remains due to us.
His response: our staff did not notify him of any copay and there are no visible signs about copayments. Whether or not he pays the invoice is his choice. Our office staff mentioned to him at the first visit that he’d be billed for any balance due. My response: while I understand your frustration, it is ultimately the patient’s responsibility to know, understand and abide by the terms of their plans, including but not limited to what services are subject to cost-share or copayment. We were willing to set up a payment plan if needed. If no response, we would seek alternative arrangements for collections.
Patient’s response received today along with a check for $ 30 for payment in full. His letter states that our billing practices are very misleading and at no time was there mention of a copay either before or after each visit and that we took it upon ourselves to consolidate all these so-called co-payments into one. All of the visits were paid on the same remittance.
I’m looking for guidance as to any specific language I should include in my final letter to the patient. I am already including this: While I am pleased with your attempt to make payment, I am unable to accept it. The money order shows an amount of $ 30.00 as payment in full for services rendered 01/22/18 through 03/26/2018. In fact, the total amount due is $ 330.00. We are not willing to accept $ 30 as payment in full.
Thanks in advance for any comments.
Billie Jean
New York