AAPC - credentialing the business side of medicine

bryson1019 · #1 03-01-2011, 10:30 AM

Is there a policy anywhere about this. I have a doc who performed an amputation on an uninsured pt. The patient is now back in the offc for a reck (2 wks after surgery) and he is wanting to charge an office visit just because the patient does not have insurance. I don't feel that he should treat that patient any different but I have been told differently by a supervisor. Can anyone help?

debrakae · #2 03-01-2011, 10:43 AM

Fraud laws state that you must bill ALL patients equally across the board. If a cash patient complains of discrimination, your provider could find himself (or herself) in a lot of trouble.

You might want to go to the CMS website and take the free Fraud webinar that they offer.

eadun2000 · #3 03-01-2011, 10:57 AM

Quote:

Originally Posted by bryson1019

Is there a policy anywhere about this. I have a doc who performed an amputation on an uninsured pt. The patient is now back in the offc for a reck (2 wks after surgery) and he is wanting to charge an office visit just because the patient does not have insurance. I don't feel that he should treat that patient any different but I have been told differently by a supervisor. Can anyone help?

Wow... seriously????? wow.. all I can say is wow... You CANNOT charge a patient during a postop period just because they are self pay. That is greed in its finest form. Besides it being ILLEGAL, it is also very, very, very immoral. Okay, stepping off my soapbox now

But seriously, that just made my blood boil.

btadlock1 · #4 03-01-2011, 11:11 AM

I may be misunderstanding you on this, but it sounds like the second visit is unrelated to the first? (Did you mean "wreck"?) If his surgery was for amputation, and the visit is for something unrelated, then the doctor would be able to charge another office visit anyways. If, however, the patient was in the office for a post-op check-up, it would be unethical and probably illegal to charge them for a visit that would normally be considered part of the surgical global package. The doctor should refrain from charging someone for services that he's not legally allowed to collect; it could prove more trouble than it's worth.

eadun2000 · #5 03-01-2011, 11:26 AM

Quote:

Originally Posted by btadlock1

I may be misunderstanding you on this, but it sounds like the second visit is unrelated to the first? (Did you mean "wreck"?) If his surgery was for amputation, and the visit is for something unrelated, then the doctor would be able to charge another office visit anyways. If, however, the patient was in the office for a post-op check-up, it would be unethical and probably illegal to charge them for a visit that would normally be considered part of the surgical global package. The doctor should refrain from charging someone for services that he's not legally allowed to collect; it could prove more trouble than it's worth.

Lol.. She is saying re-check (reck).. I had to think about it for a second there too. He is wanting to charge for the re-check because the patient is self pay and figures he can squeeze out more money and is not obligated to follow any guidelines or rules because the patient is self pay. At least that is my take as far as sqeezing out more money.

btadlock1 · #6 03-01-2011, 11:31 AM

You may find this to be a link of interest:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2517971/

bryson1019 · #7 03-01-2011, 11:36 AM

thank you all so much for your help. yes, I did mean re-check. sorry, its the texting world that has me abbreviating everything. lol!