Wiki MVA and office visit

[gcohen]

Same visit, both are addressed. Are you billing one to medical and the other to auto?

 

[amyjph]

This is always a messy situation. It's the same if a WC visit is mixed with a non-WC. We found the best thing to do is not mix if possible. If it has to be combined, make totally separate notes. From an auditing perspective it's difficult to unravel what was part of the work for the MVA vs. the "regular" visit. It's much more defensible if it's separated. I know this becomes problematic from an appointment scheduling, demographic and check-in perspective too with the way EMRs work. When the auto carrier (or WC carrier) gets the notes you can bet they will try to deny it stating it's unrelated if something else (non accepted-condition) was addressed at the same time.

 

[gcohen]

Thanks, on the same note, is it necessary to bill both?

 

[amyjph]

Thanks, on the same note, is it necessary to bill both?

That's another can of worms. The same is true in reverse, whichever payer is being billed for the visit is probably going to deny as not the responsible party if it's known there is an auto or WC claim. Plus, there are compliance, payer contract, internal company, state and federal rules & policies when it comes to billing or not billing a claim to a payer or the patient portion to the patient.