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Question Pre procedure pre screen Covid test

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Question on Covid pre procedure screening nurse visit, 99211.

Regence wants certain dx codes and modifier which I understand Insurance’s have their own policy.
I notified my manager there should be no cost share to patient. She has instructed us to adjust off the balance of the patient complains. If the patient does not complain and already paid we are keeping their money.
Aren’t we suppose to treat all patients the same, if we adjust off cost share for one Regence patient shouldn’t we for all Regence patients? She disagrees, actually states it cost too much money for us to work these claims over for the small charge we bill for a nurse visit. This makes me nervous if there was an audit.
 

thomas7331

True Blue
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Yes, you should treat all patients the same - the only exception that is normally acceptable is in the case of financial hardship of the patient, and even that should only be a reason for the balance to be written off after the provider has made a 'good faith' effort to collect the bill.

While technically a non-compliant practice, if these are small balances and your office is at least making an effort to collect and only writing it off after the patient complains, I think it's unlikely that this will cause a major problem in an audit. After all, insurance companies audit provider to make sure they're not overcharging them services, and here your provider is giving away services for free.

But in my opinion, this is not a good business practice. You're giving incentives to your patients to make complaints about their bills, and it's also unfair to the patients who do not complain. Your office should have a standard policy for billing patients that applies across the board to everyone and not get into the practice of making exceptions for particular patients in particular cases. It may solve a problem in the short run but end up creating more problems in the long run, in addition to potentially harming the reputation of the practice if it becomes known that this is how it is operated.
 

csperoni

True Blue
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I agree with the advice above.
However, wouldn't your 99211 for covid testing be billed with modifier -CS therefore no patient responsibility??
 
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We are billing with CS modifier. If a patient has paid and calls and complains we are still adjusting off.
 

khristinelouise

Networker
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Our manager is having us write off all of these because she says that's what the Cares Act says to do, but if I am understanding you correctly you are billing the pt for covid pre-procedural screening nurse visits? Would love to hear from somebody on this because I don't understand why we are writing this off. We are also writing off covid tests that are done for as a requirement to be hired for a job or that are done as a requirement before travel.
 
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