KaylaRieken
True Blue
When billing for assistants during surgeries, I know that I can charge 16% of the surgeon's fee for Medicare and 25% of surgeon's fee for Private Pay. What do I do for Medicare Advantage plans?
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Wiki Assistants at surgeries
- Thread starter KaylaRieken
- Start date
SharonCollachi
Guest
What you CHARGE and what you get PAID are two different things. Charge the same thing no matter what the insurance plan is.
thomas7331
Guest
Yes, you can charge whatever you like and it would make sense to just set all of your fees at 25% of your surgeon's fee so you're always charging the same amount - it's also the most compliant approach.
For payment, Medicare Advantage usually follows Medicare. Some MA contracts will allow a little more than the Medicare rates to providers that they really need to have in-network, but in my experience, that's the exception and not the rule.
For payment, Medicare Advantage usually follows Medicare. Some MA contracts will allow a little more than the Medicare rates to providers that they really need to have in-network, but in my experience, that's the exception and not the rule.
KaylaRieken
True Blue
Really? This is what I was taught when I started my job. Thank you.
liqgold2@aol.com
Guest
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I agree with the above. Do not bill the assistant fee the same as the surgeon's fee as recommended by some. This will only lead to confusion for all.