Practice Management Alert

Question: Our surgeon routinely has patients come to the office one week after surgery, regardless of the type of surgery, so he can check on the patient’s recovery progress. Nearly all of these encounters fall within the global period of the surgery so we are not billing a code to the insurance company; however, my doctor insists that we should be billing the patient a copay that we get to keep. Is this correct?

Iowa Subscriber

Answer: Collecting a copay for a service you are not billing to the insurance company is not correct practice.

You cannot collect a copay for a follow-up visit that you are not billing to the insurance company. You aren’t billing the service to the payer because it is included in the postoperative care for the procedure. That means you should not be charging the patient for the visit either. Routine postoperative follow-up care is included in the surgical fee and there are no charges (including copays) to the patient for routine postoperative care during the global period.