|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: GEN: How do insurance carriers do this? (long)From: Garry E. Siegel, M.D. (garrys@mindspring.com)Sun Feb 27 14:41:50 2005
> >Example - there are patients who come in for their annual Pap/etc but >are having problems &/or medication management ... if they have an >insurance that only pays for preventive care - you bill under the >preventive code ... and if they have an insurance that doesn't pay for >preventive but pays for problems -- you bill it as an E/M visit. > Joanne: Great example. Your approach is practical, but do realize that CPT tells you what you can do. I'm pretty sure that you actually can bill the preventive code AND an E/M if you deal with, for instance, an annual/pap and by the way, I am initiating HRT for menopause. In theory, you are paid for both. In actuality, you aren't. If a patient has a problem that takes up more than 50% of the time, the I bill the E/M irrespective of their coverage most of the time, and explain why. A fair number of people do not know what is covered or not, and it takes time for us to figure it out while they're in the office. That said, if the patient knows her benefits, then I might do what you do depending on the situation. What a mess it all is! Garry
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Wed Jul 2 04:39:01 2008 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.