Wiki Self-Pay Patient billing

[abctibbett@gmail.com]

I work in a gyn clinic and our providers routinely override billing the patient for a wellness exam in favor of a 99212. They do this to be considerate of the patient's finances, but I'm questioning whether or not this is legal if we don't have the same rules for everyone. Any insight into this is greatly appreciated!!!!!

 

[FriasA2014]

Self pay patients

I work in a gyn clinic and our providers routinely override billing the patient for a wellness exam in favor of a 99212. They do this to be considerate of the patient's finances, but I'm questioning whether or not this is legal if we don't have the same rules for everyone. Any insight into this is greatly appreciated!!!!!

During my 16 years of billing experience for different specialties it is up to the provider what they want to do with a self-pay patient. But financially it can be a set back for the practice. Suggest your provider to charge Medicare fees for these patients, or some type of fee depending on the situation. I would also try to establish some type of form that can give you an idea of the financial situation for self pay patients. That way the patient would at least have to demostrate that indeed they are having some type of hardship and put some effort on providing proof. Sometimes when physicians are generous the word spreads around and you have the patients that really have a hardship and the one that just want a free visit. Even a $40 charge would be a gain to the practice, after all it is a business unless it is a goverment facility, then it is a whole new story.