Wiki self pay global visits vs EM visit

[Newilkinson13]

i work for an orthopedic hand trauma surgeon...

question: one of our physicians says he can bill office visits during the surgical global for a self pay patient. Because we are not billing insurance and 99024 does not apply. My experience says "no" that everyone is billed the same regardless if patient has insurance or not. I can not find any articles or documentation to support my experience. I have looked on cms.gov. Can someone advise me. Am I wrong?

 

[thomas7331]

I agree with you, they should not do this. If your fee for a surgery for insured patients includes the post-operative care, then that fee also includes post-operative care for self-pay patients. Otherwise you are charging your self-pay patients more.

It may not be strictly illegal to do this since if no insurance is involved, the provider can contract directly with the patient for whatever fees they wish, but I would consider it a poor business practice, even unethical, and it could also leave your provider open to being accused of discriminating against someone on the basis of their insured status.

 

[Newilkinson13]

I learned over the years what you stated in your second paragraph. He is the type of provider that wants to see it on paper. Thank you for getting back to me so quickly! Have a great day!