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Podiatry Coding & Billing Alert

Reader Question:

Know When You Can Bill the Patient Directly

Published on Thu Aug 16, 2012

Question: I need to know if I can bill a patient for a supply (crutches) and not bill their insurance. We have an insurance company that is not paying us enough to cover the cost of the crutches. In this case I know that Blue Cross covers the supply but the amount they allow is well under the cost to us for that supply. If I bill the insurance I am bound by our contract with them to write off the provider discounted amount in which case our office will lose money. Is it OK if we let the patient know that his insurance will not cover our cost and then bill the patient instead? New York Subscriber Answer: No, you should not skip billing the insurance company and bill the patient instead. Since you are contracted with the payer, you cannot simply bill the patient. If you believe a payer will [...]
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