We are Urology specialty and was wondering what is a good self pay base rate for office visits? Should it be one flat rate or the Medicare allowable for each E&M level? What do others do out there?
Thanks,
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Tag Archives: Self
global periods for self pay patients
I was informed by our assistant to our director that our billing supervisor told her that global periods do not apply to cash pay. That global periods only apply to patients that have insurance. This is completely new to me. My first thought was FRAUD. Your input and direction would be very much appreciated.
Thank you
Paula
Self Diagnosis Of Medical Condition Bronchiectasis
Bronchiectasis is a lung condition where the bronchi (airways leading to the lungs) are chronically dilated (expanded). This medical condition cannot be reversed but there are specific treatments aimed at decreasing the severity of the symptoms. This article reveals more about what bronchiectasis is, its causes , and what can be done to treat the symptoms of this disease.
Bronchiectasis Symptoms And Causes
Signs or symptoms may include a prolonged daily cough associated with a foul smelling sputum, problem with breathing and respiration, exhaustion, general ill-feeling, and regular lung infection episodes.
Cause – Bronchiectasis commonly comes about from injury to the bronchi. This damage destroys the musculature and elastic structure layers that permit the bronchial tubes to contract and relax normally. Due to the lack of ability to contract, the lungs are unable to clear secretions from the lung area, this can lead to an increased danger of infection, that leads to much more damage and the vicious cycle continues.
Harm may come about due to continual lung area infections or Bronchitis, trauma caused by an obstruction in the bronchi, tuberculosis, allergies, or cystic fibrosis.
Bronchiectasis Diagnosis and Therapy
Diagnosis commences with the observation of the aforementioned signs and symptoms and evaluation by a medical practitioner. The evaluation may involve a physical examination , x-rays or a high resolution CT scan of the chest, culture of the sputum, and perhaps a bronchogram (study of the bronchi) or pulmonary function tests.
The aim of treatment is to control secretions and stop infections. Coaching will be provided on postural placement to enable drainage (postural drainage), sleeping with the head somewhat elevated and upper back clapping (percussion or clapping on the back to loosen secretions).
Smoking, air pollutants, major exertion, and rapid temp changes ought to be avoided. A physician could advise the patient to drink a lot of fluids to make mucous secretions less sticky and may prescribe expectorants to loosen secretions in bronchi or anti-biotics to battle frequent lung infections.
This is a serious medical condition and you will want to learn all you can about Bronchiectasis so you can be an active participant in your health care.
You can read more about this condition and use a free tool that walks you through your symptoms and leads you to an online diagnosis. Prepare yourself before your doctor’s visit and figure out what your symptoms means using this Medical Symptom Diagnosis Tool.
Related Medical Coding Articles
Self Pay versus Insurance you are contracted with
Hi,
I have just uncovered what may be an issue. I was told when I started with my new practice that the physician opted out of Medicare in 2010 (I have the opt out letter). I just received an audit letter/request from one of the insurances we are par with (Excellus BC/BS) for records on patients with their Medicare Replacement plan, stating that it is mandatory we send the records because it is part of the contract. I have a call into the provider rep, but it has not been returned yet. I pulled up the patient’s charts and while I see a copy of the card in the EMR, they have made the patient’s self-pay on the basis of it being a "Medicare Replacement Plan" and therefore I assume, they assumed the office was not par. These are from 2016, but I was under the impression and understanding that if you sign a contract and are par with an insurance you MUST bill the insurance company for the patient. Not make them self-pay. I am trying to find out if the physician opted out of those sections of the contract for Medicare Replacement and Medicaid Replacements, but cannot find a copy of the contract. I guess what I am asking is, if it is in the contract that we are par with their Medicare Replacement Plans, are we legally obligated to bill the insurance? Also is it illegal, to make these patients self pay? I am also thinking they are turning in their bills to the insurance afterward. Any help is much appreciated!
Ali M.
Self Pay Home Health Billing
I have a patient who only has Part A benefits under Medicare and no other insurance. He has been receiving Home Health services and our physician oversees the care plan and provides the certification and re-certification. We have been billing the patient Medicare G codes (G0179, G0181,etc). I feel this maybe incorrect. Is there any other way to bill these services to the patient as self pay?
Self limited or new problem
A 80 year old patient came in with Daiper rash, rx prescribed.
Would you count this as a self limited minor problem or New problem because of RX given under "presenting problems"?
Diaper dermatitis
Erythematous, irritated located on left buttock and right buttock
Medical Decision Making: Diaper dermatitis , observe
POC: Nystatin 100,000 units/g topical powder [nystatin 100,000 units/g topical powder] Apply BID on
buttocks , clotrimazole 1% topical cream [clotrimazole 1% topical cream] Apply BID on affected area on
buttocks
Recommendation is Explained that symptoms are caused by moisture/humidity from wearing diaper. Pt
can use clotrimazole cream BID for itch and use nystatin powder to help reduce moisture.