Wiki Preventive and Sick on the same day (Family Practice)

[lenaraamackerjackson@yahoo.com]

Hello , Our billing department (Family Practice) is trying find out the correct way to bill sick patient visits and preventive exams on the same day. Patients who have had preventive and sick patient visits on the same day, a portion of the patients sick visit is being applied to copay or deductible. Are we billing this correctly or is there a more appropriate way where the patient has no out of pocket expense?
Example: Modifier 25 was applied to 99213



Please advise,
Lenara J.

 

[jhendrix08]

You are correct in the way you're billing the sick and preventive visit. If the patient has copay or deductible, there is unfortunately no way to avoid the patient being responsible for that portion. We typically explain to the patient (if they question why they're receiving a bill) that instead of our provider asking them to come back for another appt, if time allows in the provider's schedule, the insurance will allow the provider to address and bill for the acute problem on the same day of their preventive visit. Hope that's helpful and reassuring.

 

[lenaraamackerjackson@yahoo.com]

Thank you so much!!