Wiki Non par reimbursement - ANY NON-PAR TRAUMA BILLERS

[bill2doc]

Billing for non-par trauma doc's for professional services. Kaiser paid for a pt in full for my billied 99291 but not in full for my 99292 as they stated paid by customary and resonable fee and noted an adjustment.

Anyone billing for non-par. My understanding was they should be paid in full as they are not participating and under no contract. I don't know how to know what the reasonable/customary fee is.... Can I appeal ? Can I balance bill the patient.

practicing in California

Thanks for your advice

 

[ajs]

Billing for non-par trauma doc's for professional services. Kaiser paid for a pt in full for my billied 99291 but not in full for my 99292 as they stated paid by customary and resonable fee and noted an adjustment.

Anyone billing for non-par. My understanding was they should be paid in full as they are not participating and under no contract. I don't know how to know what the reasonable/customary fee is.... Can I appeal ? Can I balance bill the patient.

practicing in California

Thanks for your advice

Answered in another forum thread...non-par do not have to accept reasonable and customary as payment in full, you can bill the patient for the difference.