Wiki Maximum Units/Claim Amount Billed for a Single Day

[Nparker1977]

Hi!
I'm hoping someone can help me with this "debate". I have been told that there is a maximum dollar amount of a claim that can be billed on a single day. The practice I work with was told by a previous billing company that payers will only allow a maximum of $5,000 worth of services per day. Because of this, they want to split a $15,000 service over three days. I know this is wrong, but they're being pretty stubborn.
Anybody have any insight?

Thank you!

 

[janet@drlb.net]

We routinely bill more than $5,000 per day for services, both for orthopedic and oncology clients. Our oncology account manager states that the limit is $99,999.00, which she occasionally exceeds due to the high cost of some drugs. It could be that the $5,000.00 amount is the threshold that the payer has established for when they require notes to support the services.