Magazine article Medical Economics

Q & A: Practice Management

Magazine article Medical Economics

Q & A: Practice Management

Article excerpt

Billing with multiple fee schedules?

My new billing service offered to create multiple fee schedules, allowing me to tailor charges to match different insurance companies' reimbursements. For example, for a 99213 visit, I could bill a lower-paying insurer $80 and a higher-paying one $700. What do your experts think of this idea?

Not much. They recommend that you bill all private insurers and fee-for-service patients the same fee for the same CPT code. Not only will this make bookkeeping simpler, but typical managed care contracts require you to charge your "standard" fee. If you have multiple fee schedules, it will be impossible to know what that fee is.

Also, charging the same fee will make it easier to track the size of the write-off you're giving each insurance company. That comparative information will be useful when it comes time to renegotiate your contracts with the carriers.

HIPAA and group visits

I'd like to offer group visits for patients with Parkinson's disease. How would this work under HIPAA?

There's nothing in HIPAA that precludes group visits, provided the patients are willing and competent to participate. Make sure patients understand that their personal medical issues will be discussed in front of others and vice versa. And stress the importance of not revealing the identity of fellow group members or discussing their concerns with others outside the group. Some physicians have their patients sign a confidentiality release prior to the meetings, but, practically speaking, such agreements are very difficult to enforce. …

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