I need someone with a background in law (or an article written by someone with a law background). I have been put in charge to find an answer to a question that everone is in disagreement on in my company. Can you bill a self-pay patient less than the Medicare allowable in the state of Oklahoma? We have patients coming in for eye exams with no insurance or no vision care coverage and we are charging a flat fee of $80.00. The medicare allowable for a 92014 is $95.12 and the allowable for the 92012 is $64.90. I have some telling me we can charge the flat fee of $80.00, others are saying we should bill all self-pay patients the 92012 code regardless of the work we do. I am not finding what I need and am really desperate for an answer. Can anyone help, please?
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