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Need Help with Billing Question

  1. Default Need Help with Billing Question
    Medical Coding Books
    Our billing company uses revenue codes for itemized billing for ASC charges. We send a list of supplies used to the billing company after a patient has surgery and they (somehow unknown to me) come up with dollar amounts and bill the insurance revenue codes for supplies. I have a patient who is requesting an itemized list of supplies and their respective charge. The billing company claims they only have the revenue codes and do not have the charges itemized in their system. They are stating that they can only send the patient a list of the revenue codes.
    I think that might be against the patient bill of rights to not supply the patient with a list of what was billed. Any ideas? Does anyone know of any documentation that will help support my case? I am getting much hesitation from the owner of the company to release the supply cost amount to me, they are saying it is "confidential". Help!

  2. #2
    Location
    Monmouth, NJ & Dover, DE
    Posts
    64
    Default
    Here is an older thread regarding itemized bills for an ASC....

    http://www.aapc.com/memberarea/forum...ad.php?t=10318

  3. Default
    Quote Originally Posted by athrailkill View Post
    Our billing company uses revenue codes for itemized billing for ASC charges. We send a list of supplies used to the billing company after a patient has surgery and they (somehow unknown to me) come up with dollar amounts and bill the insurance revenue codes for supplies. I have a patient who is requesting an itemized list of supplies and their respective charge. The billing company claims they only have the revenue codes and do not have the charges itemized in their system. They are stating that they can only send the patient a list of the revenue codes.
    I think that might be against the patient bill of rights to not supply the patient with a list of what was billed. Any ideas? Does anyone know of any documentation that will help support my case? I am getting much hesitation from the owner of the company to release the supply cost amount to me, they are saying it is "confidential". Help!
    What state are you located in? Most states have a patient bill of rights that includes the right to request and receive an itemized bill and an explanation of the charges. Also, most insurance contracts speak to this as well.

    It would not be possible for your billing company to create the bill without having the charges in their system or somewhere where the billers can reference what charges to associate with the supply. As a client, it would seem you certainly have a right to know what is being billed in your name. It might be a good idea to review your contract with the billing company and come to a better understanding of your expectations.

    It sounds like they are not respecting your rights or the patients!

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