Wiki Coding vs. Non Coding

[CHRISTINAHOCKMAN]

Are we obligated to report every office visit or can we NOT report certain types of visits because they are too costly for such a small net reimbursement? Does anyone have any links for rules, guidelines, or laws to confirm? Thanks

 

[SherryMiller]

We report all visits and encounters. The concern is are you providing services free of charge and is one payer getting benefit of that. The other issue is Medicare. We are very careful to bill all services, so that it does not appear to be an inducement to attract patients.
http://oig.hhs.gov/fraud/docs/alertsandbulletins/SABGiftsandInducements.pdf

 

[Evelyn Kim]

I would agree, every visit should be billed. Check out the Stark law and the anti-kickback statutes in your state. This could get an office into a situation where they could not only loose thier ability to bill Medicare, but could face fraud charges.

billing should not be based on reimbursment, meaning to bill or not bill based on the amount of return. Every visit should be billed to the level appropriate for the service.