Wiki Billing when POS is a Monastery?

[lhodges]

I have a physician who wants to see patients in his monastery and bill the insurance for it. Can you bill with a Monastery as a POS and if so, what POS would you use on the claim? This is new on me so any direction or advise would be greatly appreciated!

 

[jkyles]

Hi there, I think this is the most interesting coding question I've ever seen.

Could you clarify: You say the physician is at the monastery. Is he seeing patients who come to the monastery, treating other members of the monastery at the monastery or a combination?

Also, does he have a separate office/clinic in the monastery?

 

[csperoni]

DEFINITELY interesting. I thought a monastery is where certain religious groups reside (like monks.)
If the physician is treating the individual where they live, would that maybe be their place of residence therefore 12 for Home - location, other than a hospital or other facility, where the patient receives care in a private residence? Or is it not a "private residence"??
Maybe POS 33 - Custodial Care Facility: a facility which provides room, board and other personal assistance services, generally on a long-term basis, and which does not include a medical component??
Otherwise I'm left with 99 - Other place of service.
I need to brush up on my monastery knowledge.

 

[sls314]

I believe the monastery would be the patients' residence. If you can confirm that, I'd lean toward the place of service being the patient's home.

This is an interesting question!

 

[jkyles]

I agree with 12 (Home) as the POS if the doctor only treats members of monastery (monks/nuns). I don't think Home would be appropriate for anyone else, including administrative staff who work at the monastery or people who attend services at the monastery/affiliated house of worship.

After thinking about this a bit more - I assume the members have coverage through the monastery, therefore the payer should be able to tell you which POS it wants.

 

[amyjph]

Neat question. At the end of the day, is it going to make a huge difference if you were to use pos 12-home vs. pos 99-other? However, do you mean the physician wants to see external patients at the monastery because he lives there, or individuals that reside at the monastery?
Aside from the place of service question, I start thinking of a lot of other questions about this. Do they have group coverage? What services? Is the provider allowed to perform services there? I think I would want to check legal matters on this too. etc. etc.