Can you provide a discounted rate for payers who are out of network, but ALSO have a self pay rate for patients who are uninsured?
Thanks!
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Tag Archives: Self
Insurance and Self Pay
My apologies for bringing this up if having been addressed before:
Patient has insurance. Chooses to go for ‘self pay’ rate/no insurance.
Third party vendor discovers patient had insurance.
Patient paid the discounted rate. Do we ‘bill’ the insurance even if patient did not request the visit to be sent to their insurance?
The Importance of Self Audits
Self audits are an important step that medical organizations of all types can take to protect themselves from potential lost revenue (or worse) by identifying coding, billing, and documentation problems before a payer does. All practices should make self-audit a part of their coding compliance program. What Self Audits Can Achieve Self audits allow you to […]
The post The Importance of Self Audits appeared first on AAPC Knowledge Center.
Self Pay Fee Schedule vs Insurance Fee Schedule
I know a physician who charges self pay patients $ 6000 for 90960 (ESRD srv 4 visits p mo 20+), but charges Medicare $ 292.01. The Medicare allowable for our region is $ 280.84. I completely disagree with this practice and find it unethical, but I can’t find where it is illegal. Does anyone know if it is legal? Thanks in advance.
Self referring mammograms
I was wondering what referring doctor NPI other radiology practices are submitting to insurances when patients are having mammograms that are self referred. Are you using the group NPI as the referring (since the billing system will not release claims if this area is blank)? Thank you for any input!
Any Self employed Contract Coders here?
Hello I am hoping that someone can give me some insight. I work FT as a coder and wanted to broaden my expertise by maybe contracting some small physician practices in my area. Can anyone offer some advice as to how I would get started and more importantly how I would ensure the privacy of the records. Thanks in advance!
Self Pay Candida and treatment
Can a practice bill a patient with insurance as a self pay patient for the treatment of warts with candida, and not bill the charges to the insurance? Any info would be greatly appreciated.
Different Self Pay Rates
Hi guys!
So it seems my boss is in the business of offering a different self pay rate to patient’s that have transferred over from his old practice. We are a physical therapy office, and our rate at our practice is about about 45 bucks more for each visit than at his old practice. He is giving the old practice rate to transferring patients (so a discount of 45 bucks each appt) – this has to be illegal, correct? What can I cite to him to get him to stop giving these patients discounts?
And just to be clear, he can treat them for free, correct? Just not give them a discount? Any help is appreciated!
Diabetes Self Management Training
We are starting to perform Diabetes Self Management Training to our patients with HGB above 9. This is an effort to provide higher quality care to our patients and to satisfy MIPS measures. We have a medical assistant and a RN at our office. both of whom have been trained by Novo Nordisk Clinical Education program, which is certified by NCQA. We just started the one-on-one sessions with the patients today. The sessions include education on proper administration of insulin, nutrition, and developing an overall Diabetes Management plan individualized to each of those patients. Most of our patients are of Medicare age.
I am unsure how to bill for these services. 99211 for nurse visit? or 98960? Any guidance on this would be greatly appreciated.
I am unsure how to bill for these services. 99211 for nurse visit? or 98960? Any guidance on this would be greatly appreciated.
Self Funded Ins. Plan owe Interest
I am wondering if anyone can help guide me to the rule that states that a self funded insurance plan would not require to pay interest for a claim that was paid after submission approximately a year later. I challenged a payment with ASH as they are a third party that handles Chiropractic benefits for many BCBS and Cigna Members with our office. I was not under the impression that anyone was exempt from paying the interest penalty.
Please help-
Thank you,
Tessa