lindamchenry
Guest
Can anyone help me answer this question that one of my students sent to me?
This is a challenge I am facing at work.
When the insurance company authorizes our patients for an assessment it is usually 8 hours (The code is H0031). The person who used to do the billing before me, she billed the insurance company for the procedure code I mentioned above for 8 hours in one day of service so the patient will only be responsible for one day co-pay, but in reality the BCBA ( the therapist) takes like 3 weeks to complete an assessment. They don't do the assessment in one day. One week they write up the plan, the next they might do an intake and the other the assessment.
Based on billing guidelines and your expertise, This can't be billed in one day right? I should billed all the days the therapist did use the procedure code separate. No matter if the patient will be responsible for multiple co-pays. Or do you know of any guideline for this code that allows to bill everything at once.
This is a challenge I am facing at work.
When the insurance company authorizes our patients for an assessment it is usually 8 hours (The code is H0031). The person who used to do the billing before me, she billed the insurance company for the procedure code I mentioned above for 8 hours in one day of service so the patient will only be responsible for one day co-pay, but in reality the BCBA ( the therapist) takes like 3 weeks to complete an assessment. They don't do the assessment in one day. One week they write up the plan, the next they might do an intake and the other the assessment.
Based on billing guidelines and your expertise, This can't be billed in one day right? I should billed all the days the therapist did use the procedure code separate. No matter if the patient will be responsible for multiple co-pays. Or do you know of any guideline for this code that allows to bill everything at once.