Forum - Questions & Answers

Feb 27th, 2014 - sschwartz 4 

CDL and Annual Physicals

We have had repeated issues with patients who come in fot CDL physicals and paperwork for their jobs. We have normally charged cash for these exams and created a generic CPT® for them. However, we have had patients come in and say they want a yearly Annual Physical, billed to their insurance and want the CDL paperwork completed also at that time and some of our providers have done so; just including it in the visit at no extra charge. The same issue has happened with Sport Physicals required by schools; we have charged cash for those at a much lower fee that a Well Child pex. However when as child has been due for a Well Child, that has been done and paperwork for sports pex completed at same time & no extra charge. Is this practice okay? I ask because our new clinic manager who for a year has demanded we change self pay CDL's to Annual Physicals and retro bill insurances to please complaining patients has suddenly said she saw a WAC that said it is fraud to do a CDL physical/paperwork with an Annual Physical and that they have to be done at seperate visits; that going for Sport Physicals too. We billers are very confused as today she has backpeddled to please a patient and said to change the selp pay CDL charge to an Annual Exam!
So what is the correct and legal thing to do? Is there such a WAC?



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