Billing patient not present at visit

Hello:


A 5 yr olds parent came into the office. The 5 yr old was not present. Who can we bill?

Where can i find the documentation to support patient must be present in order to bill?


Thank you

Peggy CPC

It's a kid!

So Medicare rules do not apply. Go ahead and bill the visit based on time. Be sure the documentation is clear that it was a counseling/coordination of care session

Still unpaid

I recall bringing in a family for 1 hr to discuss a new diagnosis of muscular dystrophy. Child, obviously, was not present. Insurer (Cigna) refused to pay, despite appeals, because the patient was not physically there. The medical director would have preferred the 5 year old be there to see his parents fall apart.

Not a pretty story

How did the payer know the patient wasn't present when they processed the claim?

pt not present

I would bill a family counseling charge to the parents. You can not bill the insurance carrier. We bill family counseling for senior patients when their children come in to discuss care, etc. We bill a flat fee, and you should be collecting the fee at the time of service.