Wiki Can We Charge OOP and bypass insurance for rapid Covid Testing? In-house lab.

[mmiele1979]

My office would like to start doing rapid Covid-19 testing for our patients and are ready to buy the testing machine and cartridges BUT McKesson has told us the reimbursement rate through insurance is HALF of what the test costs to us. As a result, my providers are asking us how we can bill for these lab tests completely OOP. We are IN NETWORK. Can we even do this?? Do I have to check if we are contracted for this code? (most likely not as it's so new). If we CAN do this, I have questions. Can anyone help?

 

[csperoni]

As a participating provider, you may not opt out of billing insurance. A patient has the legal right to, but you cannot decide that for the patient.
You can either provide the service and bill to insurance, or not provide the service. This will be specified in your provider contracts that you may not bill the patient for covered services. Also, you may not bill to insurance and then charge the patient the additional cost.