Wiki Sports Physicals

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morgan369

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Kitts Hill, OH
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Hello, I am looking for some concrete documentation regarding charging 2 different patients differently based on their insurance coverage.
My concern is if a commercial insurance covered patient comes in for a sports physical, they are charges 25.00.. nothing is billed to their insurance.
If a medicaid covered individual comes in for the same sports physical they are not charged anything and nothing is billed to their insurance.

This feels wrong to me, but I need concrete support to change it... I feel it should be across the board, charge one charge all type of thing...
 
morgan369 said:
Hello, I am looking for some concrete documentation regarding charging 2 different patients differently based on their insurance coverage.
My concern is if a commercial insurance covered patient comes in for a sports physical, they are charges 25.00.. nothing is billed to their insurance.
If a medicaid covered individual comes in for the same sports physical they are not charged anything and nothing is billed to their insurance.

This feels wrong to me, but I need concrete support to change it... I feel it should be across the board, charge one charge all type of thing...
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In our practice the way we handle sports physicals is if the patient is due for their yearly wellness exam we will schedule a wellness exam. Our providers will fill out the required sports physical form during the wellness visit.
If the child is not due for a wellness exam we schedule a sports physical (using CPT 99429) and charge the patient $25.00 upfront.
 
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