99051- If we bill to insurance, do we also have to bill self-pay patients?

anne32

Networker
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90
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0
I am looking into this code to see if we should be billing this for our evening and weekend appointments. My question is, if we bill this code to insurances, would we also have to bill/charge self pay patients for this code? Or can we bill this to insurance only?
 

thomas7331

True Blue
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2,246
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5
As a general rule, you should treat all patients the same as far as fees and billing. In practice though, many providers do offer 'prompt pay' discounts or reduced rates to self-pay patients who have no insurance. I've been told by compliance specialists that this is acceptable for self-pay patients since no claim is being submitted for the encounter and so there isn't a risk of violating the False Claims Act. However, I'd recommend that you put this question to your own practice's legal or compliance experts because there may be local or state laws that need to be considered as well.
 
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