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Marina Posted Fri 01st of December, 2017 18:24:39 PM
Is it legal to bill a patient who is seen after hours a surcharge fee on top of their medical charges?
SuperCoder Answered Mon 04th of December, 2017 01:03:10 AM

A hospital bill may identify after hours surcharge. The surcharge represents an additional amount due on total hospital bills and whether one can bill it or not, may depend on the insurance contract and the state you are in.

For example, if a patient is seen late night in the ER (even if the emergency department is open 24 hours a day), the rationale for the after hours surcharge is that during these hours, patient volumes are generally limited, and thus these added charges help the medical practice to cover the fixed overhead expenses of having an emergency physician on-site during these hours when the patient volume is limited. However, because most insurance companies do not provide reimbursement to the medical practices for this fee, the medical practice may ultimately absorb this cost.

Hope this helps. Thank you.

Marina Posted Tue 05th of December, 2017 16:29:22 PM
So if the insurance company does not provide reimbursement, can I bill the patient for this amount? We are located in California.
SuperCoder Answered Wed 06th of December, 2017 06:35:28 AM

This would depend on the scenario and details of the procedure/service provided. The following link has some examples which may be helpful. Please see the following link for your reference:

https://californiahealthline.org/news/after-hours-er-care-may-come-with-a-doctors-surcharge/

Thank you.

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