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Filing claims on discounted visits?

  1. Question Filing claims on discounted visits?
    Medical Coding Books
    Where can I find rules and regulations on discounted fees and filing to insurance. I need to have something in writing to show the proper way to file the discounted claim.

    Thank you,
    Netzi Lemmon

  2. Default
    What do you mean by filing a discounted claim?

  3. Default
    For example sending a claim in for one amount but discounting the service for the patient. So the claim is being filed at an amount less than you expect the patient to pay.

  4. #4
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    Default
    Quote Originally Posted by 01014079 View Post
    For example sending a claim in for one amount but discounting the service for the patient. So the claim is being filed at an amount less than you expect the patient to pay.
    You mean say send the claim in for $200 but tell the patient the service is only $100? There is Federal Law that prohibits that called the False Claims Act. Nor can you send the claim for $100 and tell the patient the service was $200. If you are going to give the patient a discount then you must give the payer the opportunity for the same percentage discount off of the contracted fee schedule.

    Debra A. Mitchell, MSPH, CPC-H

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