Wiki Sports/School/Camp Physicals

[JCampbell]

Soon our office will be seeing an increase in requests for sports/school/camp physicals etc.The majority of the time, an actual preventive is not performed but pt's do not understand why it is not a covered service by the insurance company. My thought was for the patient to receive a preventive exam(if they have not already received one for the year) and then charge a form fee for the form(s) that need to be filled out during the visit.

Does anyone have a policy, regarding this, that they would be willing to share?

Thanks,
Jennifer

 

[Pam Warren]

We consider this a cash only service. We bill the 94999, and ask that payment be received at time of service, because we can't know if they had a regular physical somewhere else. Also, the requirements for a regular well-child visit are more comprehensive than for a school/camp physical, which requires only that paperwork be filled out and exam done only to satisfy those questions.

"Administrative" exams, such as those for school, licensure, etc., are a non-covered service, and if you look on the payer's policy online, you can usually find this language.

 

[Lynda Wetter]

We consider this a cash only service. We bill the 94999, and ask that payment be received at time of service, because we can't know if they had a regular physical somewhere else. Also, the requirements for a regular well-child visit are more comprehensive than for a school/camp physical, which requires only that paperwork be filled out and exam done only to satisfy those questions.

"Administrative" exams, such as those for school, licensure, etc., are a non-covered service, and if you look on the payer's policy online, you can usually find this language.

Pam, do you bill the 99499 with a charge to the insurance co, or keep them as self-pay?

 

[livingitupinok]

You just put it to self pay. We charge cetain amounts depending on the forms and PT must pay at TOS


Kristin Anderson
CPC
Oklahoma City Clinic