Wiki Internal med and Cardiology

[drossxx2]

We acquired into our multi specialty group a Cardiology practice. One of the physicians was the PCP (internal med) caregiver for some of his patients so they would only pay the PCP copay, not the specialty (cardiology) copay. Now, this physician is a part of our group, and he is only "contracted" as cardiology, so pts always are paying their specialty copay, and some of his old patients are peeved at that. Any suggestions? Anyway to avoid this circumstance?


dross@swgeneral.com

 

[jewlz0879]

Sounds like the cardio doc my group picked up. I think the problem is they have been billing incorrectly just to accomodate patients (which you can't do) and truthfully these patients should have been paying specialist copays all along. The doctor shorted himself money too.

I'm not sure there is a way around it. He/she is with a larger group now and can't get away with stuff like that any longer. We had a physician changing codes when his patients complained due to deductible and whatnot. It is my opininon you should bill the patient what their insurance company says is appropriate. If they have a $25 copay to see a specialist...well, sorry. Tell them to call their insurance and verify their benefits and they will see what THEY are RESPONSIBLE for.