Podiatry Coding & Billing Alert
Reader Questions:
Handle Nonparticipating Insurance This Way
Published on Wed Jul 14, 2021
Question: Do we have any obligation to try to collect copays or deductibles when we are nonparticipating providers with a given insurance company? New Hampshire Subscriber Answer: If your practice does not participate in a patient’s insurance plan, you can accept whatever dollar amount the patient’s insurance plan allows. However, your practice still has to collect all copayments and deductibles required by the patient’s plan. Don’t waive copays or deductibles for these patients because that violates the Stark and anti-kickback rules. Further, waiving copays or deductibles when your practice is a nonparticipating provider could very well be construed as insurance fraud.
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