copay

Doing billing for a urogyn. some carriers recongize him as a specialist and some do not. When it comes to taking copay for patient that thier carriers don't recongize him as a specialist, should the office front desk request the amount on the card listed for specialist?

I am finding that once the claim has processed the amount on the eob for copay is less than what have been taken at time of service. For example at time of service patient paid $40.00 for copay.. Oxford eob received from claim process for that date and eob states copay $25.00. so to me we should have taken the OV copay which is listed as $25.00..

I need to know if it is ok to still take specialist copay when carriers don't recongize provider as specialist..What will happen in an audit?

Copay

are you are collecting what was quoted to you at the time of service based on the eligibility verified?

copay

the front desk is going by what is on the patient insurance card at time of service. If there is a specialist copay listed they are taking that. if there is only one copay listed there is not issue...Only those that have OV/spec/urgent care/er

copay

This seems like a carrier by carrier issue, and I think you'll have to contact them individually.