Assistant Surgeon not allowed

AMADDOX

Contributor
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Lexington, TX
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Hi there,

I have a question regarding LSA's as assistants? The LSA I work for previously assisted on a surgery that does not allow an assistant. He is not contracted with the insurance and he received a denial stating that on that procedure assistant surgeons are not allowed, therefore the patient is not liable. My question: Can he still balance bill the patient for a portion of his services due to the fact that he is not contracted with that insurance?

Any input would be helpful and appreciated. Thx
 

katic23

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My initial inclincation was to say yes, that he can bill the member because he is not contracted, but to be safe, you could consult with your local area medical association's legal department to get their advice. I have had to do this once or twice and found it to be very helpful.
 
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