We have a lot of patients who come in for DOT physicals. Other than that they don't often seek regular or preventative medical care. Many of our providers will "take the opportunity" while the patient is in the office to do a CPE. There seems to be little consistency with the way the appointments are initially scheduled (DOT vs CPE), and notes and coding are not really consistent either, causing a billing nightmare.
We know DOT physicals are not billable to insurance, and when visits are scheduled and carried out as such, the patient pays at the time of service. When a provider decides to do CPE instead of just a DOT exam, sometimes the patient has paid the DOT exam fee, sometimes we are "supposed" to bill insurance (no fees collected at time of check out - and we in the billing office have no idea what the patient's understanding of their responsibility is).
My question here is: Are there any compliance related issues in doing a different type of visit than the patient was requesting/needing/scheduled for without the patient being advised of the situation and any possible financial responsibility?
Thanks for any insights...
We know DOT physicals are not billable to insurance, and when visits are scheduled and carried out as such, the patient pays at the time of service. When a provider decides to do CPE instead of just a DOT exam, sometimes the patient has paid the DOT exam fee, sometimes we are "supposed" to bill insurance (no fees collected at time of check out - and we in the billing office have no idea what the patient's understanding of their responsibility is).
My question here is: Are there any compliance related issues in doing a different type of visit than the patient was requesting/needing/scheduled for without the patient being advised of the situation and any possible financial responsibility?
Thanks for any insights...