Patti Posted Sat 01st of December, 2012 01:06:54 AM
After hours or during office time, insurance companies do not pay for telephone calls. We have a service that charges us $11 for each call after 10pm until 8am in the morning. Our message on this emergency line states there could be a fee for this service. What are the codes we should use for this service? What if the insurance does not pay for the calls, what can we do? The calls are well documented with almost every detail imaginable.
SuperCoder Answered Mon 03rd of December, 2012 18:50:55 PM
This article lays it out pretty well, including the codes to use and when to use them, checking with the insurer to see if it's ok to charge the patient, etc.: http://www.ama-assn.org/amednews/2010/02/01/bica0201.htm. It's possible state law may prevent balance billing the patient for something the health plan doesn't cover, so that needs to be checked, too.