Forum - Questions & Answers

Jun 21st, 2011 - Shannan 28 

billng pts instead of insurances

I have a question and need some input to take back to the new physician I am billing for. He is a blue cross/blue shield provider, however he will have a pt come in for a testosterone injection or any other kind of injection and he will bill the insurance for the office visit but he has his pts pay for the injection seperatley. I am questioning the legallity of this practice. Any input??

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Jun 21st, 2011 - ginaveronica 6 

re: billng pts instead of insurances

well two things here,first,just because the dr feels/thinks he wo nt be paid is not a good enough reason to make the patient pay ahead of time.if it is a ded.issue,or copay different story,i worked at the oregon bcbs for over ten years and if we found out a dr billed this way,he would be red flagged and all claims would be revied and then a rep would go to the providers office and review chart notes,to make sure that he is not over coding as well as not UNDER coding,you can be in trouble for both.hope this help.bottom line,this dr better be careful...

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