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This isn't necessarily a coding question but I'm doing some research and I want to see if I can track something down. For years, I was told or understood that if you saw a patient that was in a federally funded plan and you were a participant in any federally funded plan - i.e. Medicare - you could not charge the Medicare patient more than what you would have charged a private pay patient. In other words, you couldn't have two fee schedules - one for Medicare patient's and one for private pay patient's that was below the Medicare par amount. The problem is I cannot find this anywhere on the internet in the Federal register. Can someone help me out? And is this correct?
I know there is some leeway so to speak from organization to organization in regards to how to handle indigent or private pay patients and also rules regarding establishing indigency. With the economy the way it is, we are going to be seeing more and more private pay or underinsured patient's and I want to make sure we are handling things appropriately.
Also - does anyone know if this rule might be different for "Doc in a box" clinics so to speak?
Thanks!
Janet Gryder
I know there is some leeway so to speak from organization to organization in regards to how to handle indigent or private pay patients and also rules regarding establishing indigency. With the economy the way it is, we are going to be seeing more and more private pay or underinsured patient's and I want to make sure we are handling things appropriately.
Also - does anyone know if this rule might be different for "Doc in a box" clinics so to speak?
Thanks!
Janet Gryder