tflowe
New
I have reviewed other postings about correct billing for health plan mandated biometric screening/wellness screening for premium incentives. There are companies that offer to obtain blood samples and vital statistics on-site for employers. However, they do not qualify as providers and therefore must rely on a physician practice to "review the data" with the patient and submit a claim to the carrier. The company collecting the data bills the provider and the provider collects payment from the health plan for preventive care.
I have two concerns: 1) Some data collection agents are saying these can be done on-site at an employers location and then be billed through the provider's office. Since there is no site-of-service code for "on-site at an employers," it is incorrect to use place of service 11 and to bill using preventive codes for payment. 2) Preventive codes pay higher because there is more involved in the exam. I find it hard to believe that pelvic and prostate exams are being done at the employers facility.
Since the biometric sheet often in questionairre form, our providers tend to review the labs and sign. This obviously does not meet the criteria for preventive care exams.
What are your thoughts?
I have two concerns: 1) Some data collection agents are saying these can be done on-site at an employers location and then be billed through the provider's office. Since there is no site-of-service code for "on-site at an employers," it is incorrect to use place of service 11 and to bill using preventive codes for payment. 2) Preventive codes pay higher because there is more involved in the exam. I find it hard to believe that pelvic and prostate exams are being done at the employers facility.
Since the biometric sheet often in questionairre form, our providers tend to review the labs and sign. This obviously does not meet the criteria for preventive care exams.
What are your thoughts?