Question Covid Specimen collection - Cash based?

sbeauregard

Contributor
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10
Location
Lake Wylie, SC
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0
I have a pediatrician located in Texas who would like to bill patients directly for the specimen collection only for a covid test. No billing would be sent to insurances. All specimens will be sent to an outside lab. Are there any restrictions on this? Can they bill Medicaid patients as well?
 

csperoni

True Blue
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1,601
Location
Selden
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3
1) Is the provider contracted with any insurances? If so, it would be against your contract to not bill insurance and require patient payment.
2) Medicaid patients. Different states have different rules about this. Some allow out of network clinicians to provide the service & bill patient, but you must notify the patient (in writing) that they can obtain the care in network.
3) With the CARES act, there are even further restrictions related to charging patients for covid testing and/or treatment https://www.google.com/url?sa=t&rct...g-advice.pdf&usg=AOvVaw2Y3KRkmgLh2unoS8hGfW5d
4) If all of the above lead to the determination that the provider may charge the patients, don't forget that the federal No Surprises Act requires the patient to be given a written estimate within a certain timeframe of scheduling an appointment.
 
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