Results 1 to 5 of 5

OB Care split billing within same practice

  1. #1
    Red face OB Care split billing within same practice
    Medical Coding Books
    Okay, I know each practice probably has different ways of billing Global OB Care. I need several opinions and possible back-up on how to bill when the delivery doc is not the patient's OB/Gyn. But the delivery doc is in the same practice but was just the provider on-call when patient delivered. How do you split that up? I have some ideas but need some more speciality input.

  2. Default
    if they are in the same practice you cannot split bill.

  3. #3
    Madison Area Chapter in Madison WI
    I agree. I ran into this situation not too long ago. From a coding perspective, the services were provided by the same practice, same specialty, so the global service is billable.

    Many clinics pay their physicians based on the actual services they provided; therefore they would like to bill the services separately. This is an internal business issue for the clinic and doesn't change the coding rules.
    Happy Coding, Claudia

    Claudia Yoakum-Watson, CPC
    Coding, Compliance, & Reimbursement Solutions
    [email] - website

  4. #4
    Red face OB Care Split billing in same practice
    Okay, so I should tell the physician's that it is considered unbundling, which is what?...Fraudulent? I am having a hard time convincing them that this is incorrect coding. They "get paid". Which we all know does not mean correct coding. Any suggestions.

  5. Smile
    I have this scenario quite often. Our physicians agreed on a set fee they are reimbursed when they deliver another provider's patient while on call. This fee is collected internally and never billed to ins or pt. We have one set amount for vag.del and c/s. The global fee is billed to insurance and once they pay we adjust the amount due to the delivering dr from this charge and allocate that amount to an internal charge for the delivering physician. This system has worked quite well for us (15 ob/gyns) as well as giving us a tracking system to make sure the delivering physician is getting reimbursed for their services.


Similar Threads

  1. split billing
    By in forum Ophthalmology/Optometry
    Replies: 8
    Last Post: 08-24-2015, 07:50 AM
  2. Split Billing help
    By in forum Billing/Reimbursement
    Replies: 1
    Last Post: 03-25-2013, 08:22 AM
  3. Split billing
    By mslori7 in forum E/M
    Replies: 1
    Last Post: 03-03-2010, 06:13 AM
  4. OB Split Billing
    By laneylyn1978 in forum OB/GYN
    Replies: 4
    Last Post: 01-09-2009, 05:00 AM
  5. Split billing ante partum care
    By barbacasec in forum OB/GYN
    Replies: 2
    Last Post: 04-09-2008, 02:05 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.