aarnold13
Networker
I work in an office that has an occupational health department. People can call and schedule pre employment physicals through this department. We have been having more and more companies(mostly schools) that require the employee to have a work physical at the cost to the employee.
Recently there was a patient on the medical card that needed a preemployement physical but did not have any money and we are not able to bill the 99450 to public aide. We were able to schedule the person for a yearly physical, which they were due for, and have the Dr fill out forms while at the visit. Then the visit was billed out as a 99395. I know there is a FINE line doing this but now the Occupational Health person is kinda "coaching" self pay people to schedule a yearly physical and bring forms along so that the visit can be billed to insurance. I feel really uncomfortable with the whole thing and I wanted to know from some of you more experienced coders if this process is OK to do or if it would be considered fraudulant?
I can understand that if they are due for a yearly physical anyways that the dr is doing basically the same stuff, just more indepth with history ands counciling BUT if the SOLE reason the patient is coming in is for a pre-employement physical then shouldn't we just leave it at that and not tamper with it anymore?
Thanks for any insight! It is GREATLY appriciated!
Recently there was a patient on the medical card that needed a preemployement physical but did not have any money and we are not able to bill the 99450 to public aide. We were able to schedule the person for a yearly physical, which they were due for, and have the Dr fill out forms while at the visit. Then the visit was billed out as a 99395. I know there is a FINE line doing this but now the Occupational Health person is kinda "coaching" self pay people to schedule a yearly physical and bring forms along so that the visit can be billed to insurance. I feel really uncomfortable with the whole thing and I wanted to know from some of you more experienced coders if this process is OK to do or if it would be considered fraudulant?
I can understand that if they are due for a yearly physical anyways that the dr is doing basically the same stuff, just more indepth with history ands counciling BUT if the SOLE reason the patient is coming in is for a pre-employement physical then shouldn't we just leave it at that and not tamper with it anymore?
Thanks for any insight! It is GREATLY appriciated!