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Billing question regarding billing for a provider who is also the patient

Tierni Posted Tue 09th of June, 2015 20:27:06 PM

Have a provider who performed a procedure on himself and now wants to bill for it. Is this legal? If not, please provide documentation to support your advice.

SuperCoder Answered Wed 10th of June, 2015 05:02:05 AM

“A physician, except in an emergency or in cases which are manifestly not serious, refrain from treating himself.

The general rule has 2 exceptions:

1) In emergency, such as an acute and potentially fatal condition for which the physician must treat himself while awaiting the required assistance. Fortunately, it is rarely to have this exception.

2) It applies to minor and commonplace conditions, which occur much more frequently. The classic example is tonsillitis. Apart from these exceptions, the prohibition on self-treatment is imperative; it applies to all physicians, even when the physicians requiring care have all the knowledge they would need to provide optimal treatment to patients consulting them for the same conditions.

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