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Podiatry Coding & Billing Alert

Reader Questions:

Accepting a PFFS Plan is Your Choice

Published on Fri May 21, 2010

Question: Our practice is considering accepting patients with PFFS plans. We've heard that some patients are starting to have them, but we're not sure whether we're going to accept them or not. Are PFFS plans beneficial for us? California SubscriberAnswer: PFFS are Private Fee-for-Service plans, which are non-network plans. These plans let members receive care from any doctor or hospital that accepts the plan's payment terms and conditions.If your practice decides to accept these terms, you would become a "deemed" provider. Plan members can receive covered services from any deemed provider in the U.S. However, member patients must confirm that the provider is deemed every time a service is provided. PFFS plans are different from Medicare Advantage plans because they do not require a doctor or hospital to contract with a health plan to provide services. This means that doctors or hospitals that do not agree to the PFFS plans' [...]
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