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WHEN UNDER CONTRACTED INSURANCE...BILLING IS A MUST

Jenny Posted Fri 01st of May, 2015 17:27:00 PM

I am looking for supporting information showing that you must bill the insurance especially when you are under contract with them... My provider is saying NOT to bill the insurance for a DOT(department of transportation) Physical exam, and only make the patient pay for this service. I have always been taught that when under contract you must bill the payer, and accept payment. They only way the patient would be responsible for the remainder would be "IF" they signed the ABN for a 99080 form fill out fee. Can we legally do that??? Any help would be greatly appreciated!
Thank you,
Jenny

SuperCoder Answered Mon 04th of May, 2015 02:39:56 AM

DOT Physicals are paid by the employer or the employee and are never billed to the Insurance. DOT and CDL physical exam is employment-related and is not covered under insurance plans.

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