Billing for Telehpone Calls When Some Carriers Pay and Some Don't
Published on Thu Jul 01, 1999
Pediatricians are often required to spend a great deal of time on the telephone answering questions for anxious parents. And while there are codes for this service (99371, 99372, and 99373), not all insurance companies pay for them. And therein lies the difficulty. If you only bill the insurance companies who pay for these codes, and provide the same service to other patients for free, youre not being fair to the insurance companiesand they will be the first to let you know that they consider that fraud. Third-party payers take an equally dim view of billing all insurance companies and then writing off the charge when it is denied. To further complicate the issue, some carriers do not allow you to bill patients for services which they dont cover. In addition to some form of write-off, the other two options are (1) to bill all insurance companies, and then bill the parents for the denied charge; and (2) to bill nobody and provide the service free, thinking of it as marketing or public relations. Whats the solution?
Consider It a Write-off
If you were to look at it from a strictly business standpoint, you would bill out these codes, because about half of the plans do pay, says Linda Kortanek, office manager for Northpoint Pediatrics, a six-pediatrician practice in Indianapolis, IN. Three years ago, Kortanek tried to do just this, but the experiment failed, because parents were infuriated when they received bills after the insurance company denied the claim. So, after having tried it the other way, Kortanek now considers the service a free benefit.
We couldnt only write it off for the patients in plans that dont pay, because that would have been discriminatory, she explains. We cant say to one plan, Because youre willing to fork over the money, were going to make you pay, and then say to another plan, Since you dont pay for telephone calls, were not going to charge you or your members for this service. The first plan thinks they should get the same benefit the second one gets, Kortanek explains. And you can see
their point.
So what Kortanek did was to bill all the plans, and then bill patients when plans denied the charge. But this created so much ill-will that we had to stop, she recalls. It was so inflammatory that it wasnt worth it.
Parents had many comments on the practice of billing, but the gist was that they view telephone calls as a benefit that should be free. And while some pediatricians do bill parents for telephone calls, Kortanek [...]
