Wiki Wellness Billing

[cbroderick]

We were contacted by an employer to come on site and do biometric screenings and HRA Assessments to their employees. We gave them a rate per employee to do this but they came back with saying... other providers have done this for us and billed our insurance company for the services.

Is this possible?

They told us the insurance paid 100% and used there Annual Preventative Wellness Benefit (ie..99385-99387 and the medicare code if the case)

Again... Is this possible?

Would these codes be used or would others?

Help!

 

[tflowe]

Biometric screening discussion

I have reviewed other postings about correct billing for health plan mandated biometric screening/wellness screening for premium incentives. There are companies that offer to obtain blood samples and vital statistics on-site for employers. However, they do not qualify as providers and therefore must rely on a physician practice to "review the data" with the patient and submit a claim to the carrier. The company collecting the data bills the provider and the provider collects payment from the health plan for preventive care.

I have two concerns: 1) Some data collection agents are saying these can be done on-site at an employers location and then be billed through the provider's office. Since there is no site-of-service code for "on-site at an employers," it is incorrect to use place of service 11 and to bill using preventive codes for payment. 2) Preventive codes pay higher because there is more involved in the exam. I find it hard to believe that pelvic and prostate exams are being done at the employers facility.

Since the biometric sheet often in questionairre form, our providers tend to review the labs and sign. This obviously does not meet the criteria for preventive care exams.

What are your thoughts?

 

[airart]

Health Fair Proposal Contract

When I have attended a Health Fair at work, they usually have the local technical or community college there to practice on us employees with blood pressure and blood type simple tests. Heath questionnaires are also given using a laptop the employees can sit down and answer. Usually the employer will give away prizes in a drawing for entries received.

Its good education and training for the students and the employees get to know their blood type and if they need to see their doctor regarding their blood pressure levels. The schools usually are cheaper more than a provider's office and they use a Health Fair Proposal contract to negotiate a rate per employee that the company has. I don't know any that actually bill the employees insurance as not all employee's even take the companies insurance it provides.