medical billing transcription supplier information

Q.

Your April 2004 column in Geriatrics discussed charging Medicare patients a no show fee. The article stated that this is allowed if all non-Medicare patients are also billed. The article states that staff may not use an office visit code for such billing purposes, but can create an in-house code, such as "NOSHO." I have always understood that physicians are absolutely not allowed to bill Medicare patients as no-shows, according to the Medicare Compliance Manuals, and Medicare service representatives. My question--who is correct, you or Medicare?

A.

The answer is simple: not all the information you read or hear is accurate. In 2004 the Government Accountability Office conducted a study on Medicare customer service representatives. The government watchdog said: "During our test calls, Medicare customer service representatives typically provided incorrect and incomplete answers to the 300 policy-oriented questions we posed. Only 12 out of 300 responses were correct and complete."

We posed your question to Terrence Kay, director, division of practitioner and ambulatory care, Centers for Medicare and Medicaid Services. He writes, "CMS's policy is to allow physicians and suppliers to charge Medicare beneficiaries for missed appointments, provided that they do not discriminate against Medicare beneficiaries but also charge non-Medicare patients for missed appointments. The charge for a missed appointment is not a charge for a service itself (to which the assignment and limiting charge provisions apply), but rather is a charge for a missed business opportunity. Therefore, if a physician's or supplier's missed appointment policy applies equally to all patients (Medicare and non-Medicare), then the Medicare law and regulations do not preclude the physician or supplier from charging the Medicare patient directly."

# posted by Medical Information : 5:48 AM