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Thread: Provider Based billing fees/location

  1. #1
    Join Date
    Apr 2007
    Traverse City, MI

    Default Provider Based billing fees/location

    AAPC: Back to School
    We switched to Provider Based Billing on 08/01/2011, with "assistance" from a consultant. The policy that we are supposed to follow is different for charge entry fees & location depending on the insurance carrier (Government-Medicare/Medicaid/Tricare etc., versus a Commercial insurance or self pay). I can not find any documentation that this is an appropriate practice to follow. Can anyone verify this for me please? Thank you!!

  2. #2
    Join Date
    Apr 2007
    Dover Seacoast New Hampshire


    It's my understanding that provider-based billing is recognized only by government payers. The expert on this is Debra Mitchell, and she posts on this board quite a bit.

    We were doing provider based billing for a couple years (and switched back). We did the split billing only for the government payers....the other payers were exclusively on the 1500. We did, however price our fees so that the total charges were equal, regardless of the payer.
    Pam Brooks, MHA, CPC, PCS, COC
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

  3. #3
    Join Date
    Apr 2007
    Traverse City, MI


    Thanks Pam!

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