Insurance Billing vs. Cash billing Issue
Monday, September 24, 2018
Posted by: Bridghid McMonagle | OANP Board Member
I recently ran in to another ND who told me an unfortunate situation. Apparently, Providence reached out to several ND’s asking for reimbursement (from the ND) due to over payment to the patient. It sounds like several ND’s paid $10,000 to Providence over this. At least one ND has worked with an attorney over this matter. This has not happened to me personally. If you are out of network with an insurance company, you still need to circle appropriate codes on your superbill. You can also charge per time and not have any codes on your superbill.
This is a reminder (in my humble opinion and not speaking for OANP):
1. Always speak to an attorney who focuses on medical cases.
2. If you circle codes on a superbill, make sure your chart notes justify those codes.
3. Remember, your malpractice attorney’s first allegiance is to their employer. It does not cost that much to speak with a private attorney.
If you have had any legal battles, been contacted about anything similar to this, please share with the OANP or myself. I am happy to keep any communication anonymous and place the stories in the OANP newsletter. OANP members get free attorney consultations. I think it is important to know what is happening in the community and learn from each other.
In private practice things are getting very complicated. Patient’s deductibles are high, labs charge unpredictable amounts, and patients end up being confused. It takes a long time to try to explain these things.
Let’s work to keep each other informed! If you would like to get in contact with me, please send request to firstname.lastname@example.org, and she will respond with my contact information.