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Wiki Fee Schedules

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WHAUN

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Nampa, ID
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We have our regular fees, but our providers would like to bill Medicare at Medicare allowed rates. Why or why not is this a good idea? Does anyone else do this? Everywhere else I have worked, I have always submitted charges at the same rate across the board regardless of insurance. You have your fees for insurance and you have your fees for non-insured patients. Please help! Thanks!
 
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My best recommendation is to bill all at the same rate for everyone, regardless of carrier. There can be legal/compliance implications for doing otherwise, besides financial.
For example, patient comes in - states insurance is Medicare and Cigna. You bill Medicare at $200. It turns out the Cigna is actually primary. You would now be billing Cigna at $200.
Regarding non-insured patients, your FEE should also be the same. You may DISCOUNT that fee for the patient paying at the time of service. I know it seems like a technicality, but again, can have legal/compliance implications.
 
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Perfect! Thank you so much for your input. I have been thinking this way all along but started second guessing myself so I just needed to hear it from others. Glad I'm not losing my mind : ) thanks again!!
 
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