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Global billing issue

  1. #1
    Default Global billing issue
    Medical Coding Books
    I am banging my head right now...

    We had a surgeon that left our practice, last day was 6/30/09. It just hit me last week that we have billed all her surgeries as global, even though she will be doing follow-up thru her new office. It doesn't appear to be too many patients affected by this but we still need to fix it. Has anyone else ever had to do this? What was the best way to go about it? Did you rebill and have the insurance take back or did you work with the new office?

    Any advice is appreciated. I am thinking we will be stuck doing refunds and rebilling everything but I am trying to be positive....

    Laura, CPC

  2. Default
    You billed all her surgeries as global to what?
    Also if she left your practice on 6/30 then any dates of service after that you should not be billing for.
    I'm not really sure what you did. Can you explain alittle more?

  3. #3
    We billed the global surgey, which includes the 90 day follow-up. The problem is we may have only done 30 days of that follow-up before she changed offices. So she will do the other 60 days thru the new office.

    We aren't billing for dates of service after she left, when she submitted her surgery charges for billing on dates of service when she was here they got put thru as always, which as I stated includes the follow-up.

    Laura, CPC

  4. #4
    Did you have an arrangement when she left? We have had this happen. However, it is agreed that all services rendered, such as surgeries, are billed with the global and payment is made to the practice. If she sees those patient's in follow up in her clinic, she doesn't bill, and she eats it. It could also be possible to leave the billing as is and cut her a check per patient or something.

  5. Default
    So you didn't do anything wrong. You billed out what you were supposed to and now it is in the new offices hands. You can't help that she did surgeries that carry a 90 day global and now she left the practice before the global ends.
    It is not your problem, you don't need to refund or have anyone take back anything.

  6. #6
    I wouldn't refund anything either. It's apart of leaving a practice, a surgical one at that. Anytime you leave a practice to start a new clinic or join a new clinic there is loss of revenue -- and that's just one source.

  7. #7
    Interesting, thanks for the replies. I will have to check on her contract to see what it states.

    I have worked with doctors before that this type of situation has triggered an audit by the carriers, and we certainly don't want to do that or do anything that is wrong, but the fact that she is the one doing the follow-up does put a different spin on it.

    My previous experience has been when someone else did the surgery and we did the follow-up or vice versa.


    Laura, CPC

  8. #8
    Thank you so much!!!

    I had her contract pulled and it clearly states any fees collected during her employment go to the employer, us!

    This saves me so much stress and work.

    Laura, CPC

  9. #9
    Told ya

    Just remember ... when it comes down to a provider and their "personal money" ... pull that contract !!! Everything is usually clearly defined.

    So thankfully no action needs to be taken! Stressing out over nothing!

    Happy Friday!

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