Results 1 to 4 of 4

Billing Insurance (Fees)

  1. #1
    Marion, OH
    Talking Billing Insurance (Fees)
    Medical Coding Books
    We recently signed a new contract with one insurance company that gives us an enhanced fee for procedures done in the office. I have always heard that you should bill all insurance the same rate. My question is, if we need to raise our fees because of this enhanced fee, do we raise it for just the one insurance company or across the board?

  2. #2
    Tuscaloosa, AL
    We have one set fee (or charge) for a procedure with different allowables based on our contracted insurance's fee schedule.


  3. #3
    Marion, OH
    That is how we are currently billing but some of the enhanced fees would increase office procedures by $100 to $400. Do I legally have to bill all the same and just adjust off more for the ones without the enhanced fee or can I just bill the one insurance company more?

  4. #4
    Many insurance contracts have wording that covers this situation. It boils down to you can't bill them anymore than you would anyone else for the same service.

    If you want to increase your rates for the one, you should for everyone else as well.

    As far as the legality, I don't know. Ethically it would be wrong to charge some people more because of the type of insurance they have.

    Laura, CPC, CEMC

Similar Threads

  1. Pro fees and fac fees for Conscious Sedation?
    By atheri992 in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 05-05-2014, 12:42 PM
  2. Cash Fees Vs. Insurance Fees
    By in forum General Discussion
    Replies: 1
    Last Post: 01-06-2012, 05:12 PM
  3. Billing fees
    By jod867 in forum Billing/Reimbursement
    Replies: 0
    Last Post: 03-15-2011, 03:23 PM
  4. Billing Auto Insurance vs Private Insurance
    By kathymoon in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 08-08-2008, 07:47 AM

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.