Wiki Billing employees/families that are patients

[corikr77]

Our clinic wants to include medical services as a part of our benefit package for employees and their immediate family members. The intent is essentially to bill the employee's insurance company for services they received from our clinic, but any co-insurance/co-pay/deductible that the employee/patient would normally be responsible for would be written off as an employee courtesy. I have put many, many hours researching this and the information that I have found so far is that this should not be done for Medicare and private payers alike. (Anti-kickback laws, mis-representation of physician fees, fraud/abuse etc.) Our manager has checked with a lawyer and another clinic and they are saying that this intended policy is allowed, but I cannot find any actual documentation to support this. Does anyone have any documentation that they can provide either for or against this?

I look forward to your feedback! Thanks for your help!

 

[LouiseR1]

Hi Corey!

The best thing to do is to read the languange in the contract betweent the insurance and your practice. In the contract of that particular payor there should be language that discusses collections of patient responsibility, this may discuss writeoffs etc.
Good luck and hope this helps....

Louise