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global period meaningless?

  1. #1
    Default global period meaningless?
    Medical Coding Books
    We have a patient who is no longer in global...several weeks out.....with no complications.....coming in for follow up on TKA.

    She is questioning why she will be billed office visit (out of global) her insurance company told her billing after global has ended "is doctors discretion"...

    Has anyone had to deal with this?? I dont even really know how to respond

  2. Default
    Quote Originally Posted by PLAIDMAN View Post
    We have a patient who is no longer in global...several weeks out.....with no complications.....coming in for follow up on TKA.

    She is questioning why she will be billed office visit (out of global) her insurance company told her billing after global has ended "is doctors discretion"...

    Has anyone had to deal with this?? I dont even really know how to respond
    The insurance told patient that it's the Doctor's discretion whether to charge an office visit or not?! Wow, what a cheezy thing to tell a patient. Makes the patient feel like the Doctor is greedy & not caring about the patient! So unprofessional. Just explain to the patient that the Global period after surgery is 90 days (if that's the case for this sx) and beyond that it is legal and customary for Provider to charge for the continuing care. Every provider I know does it this way. I've never heard of a provider continuing the No-charge care after the global period has ended! I then would contact my Provider Representative at that insurance and tell them what customer service told our patient and how unprofessional that is.

  3. #3
    Default
    I thought the exact same thing.

    I could understand it if they were few days out (of global) and there was still a complicating factor...I know some docs have included in global...but that is rare.

    I did not even think of report to provider rep.....thank you...I will be!

    I wonder if they feel it is "provider discretion" if we would like to bill office visits all through the global huh?

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