Sounds like an AFLAC type policy that pays their clients personally for certain medical circumstances. They are not in any way tied to the patient's regular medical insurance. This type of policy would pay whether the patient's medical insurance was billed and paid, or not. The patient is asking for exactly what took place, a statement showing the CPT code for the procedure done with a $0 amount as no billing was sent.
Originally Posted by sjsantjer
Doctors are allowed to provide free care at their discretion, most do not as it is not good for the bottom line. This is considered professional courtesy. The unethical part would be if the doctor billed medical insurance for a friend or relative, and then wrote off the difference that was considered patient responsibility.
From the AMA website:
"Physicians should exercise caution in extending professional courtesy where the patient may be in a position to make referrals. If the physician's intent behind extending professional courtesy is to generate referrals for Medicare or Medicaid covered services, the government will be in a position to prosecute a fraud or abuse case for a violation of the anti-kickback law.
Extensive research has failed to uncover any instance where a physician has been prosecuted by either the OIG or the DOJ for fraud or abuse based on the extension of professional courtesy. Furthermore, the OIG is unlikely to initiate a fraud or abuse investigation related to the traditional act of professional courtesy. On the other hand, prosecutions for the routine waiver of Medicare coinsurance have involved schemes to provide medically unnecessary services, and were not examples of professional courtesy."
Arlene J. Smith, CPC, CEMC, COBGC
AAPC Tacoma WA Chapter
Past-President 2013 and 2011
Member Relations 2008
AAPC NAB 2007-2009