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Charging admin fees

  1. Question Charging admin fees
    Medical Coding Books
    Help! We charge Pt's up front for possible non-covered vaccines; Zostavax, TDAP (Medicare), etc. My office policy is to charge the $34 admin fee only to Pt's w/ an OV. If they walk in w/out an appt no admin charge is applied to cost of vaccine. The reasoning is because insurances won't pay admin fee without an OV so we don't charge for it. Some of the providers are concerned about this. How ok is this? It seems not right & I would appreciate any help or advise on this.
    ~L

  2. #2
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    Quote Originally Posted by lserr View Post
    Help! We charge Pt's up front for possible non-covered vaccines; Zostavax, TDAP (Medicare), etc. My office policy is to charge the $34 admin fee only to Pt's w/ an OV. If they walk in w/out an appt no admin charge is applied to cost of vaccine. The reasoning is because insurances won't pay admin fee without an OV so we don't charge for it. Some of the providers are concerned about this. How ok is this? It seems not right & I would appreciate any help or advise on this.
    ~L
    Why would an insurer make you charge them more before they pay anything? The only reasons they wouldn't pay an admin, is if:
    1. The vaccine's not covered
    2. They don't cover injections

    The only difference an E/M should make is where a copay's applied. You should charge everyone the same way. Hope that helps!

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