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Non par reimbursement - ANY NON-PAR TRAUMA BILLERS

  1. Default Non par reimbursement - ANY NON-PAR TRAUMA BILLERS
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    Billing for non-par trauma doc's for professional services. Kaiser paid for a pt in full for my billied 99291 but not in full for my 99292 as they stated paid by customary and resonable fee and noted an adjustment.

    Anyone billing for non-par. My understanding was they should be paid in full as they are not participating and under no contract. I don't know how to know what the reasonable/customary fee is.... Can I appeal ? Can I balance bill the patient.

    practicing in California

    Thanks for your advice

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    Quote Originally Posted by bill2doc View Post
    Billing for non-par trauma doc's for professional services. Kaiser paid for a pt in full for my billied 99291 but not in full for my 99292 as they stated paid by customary and resonable fee and noted an adjustment.

    Anyone billing for non-par. My understanding was they should be paid in full as they are not participating and under no contract. I don't know how to know what the reasonable/customary fee is.... Can I appeal ? Can I balance bill the patient.

    practicing in California

    Thanks for your advice
    Answered in another forum thread...non-par do not have to accept reasonable and customary as payment in full, you can bill the patient for the difference.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

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