Billing & Collections: Avoid On-call Fraud Accusations

By Author: Julia Rose
Total Articles: 89
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Sometimes, your physician might cover for another physician or that physician might cover up for your physician. If you are billing incorrectly here, you could be readying yourself for charges of fraud.


But if you keep a few simple answers to the top three on-call billing questions, you'll be able to file the claims correctly.


Which physician bills for the services?


If your physician is on call and handling patient services for another physician, you shouldn't let the other physician bill for the services. Even though a patient sees a particular physician, that does not mean that physician can bill for any services related to the patient's care. When your physician provides a service, even while on call for another doctor, you should bill the services.


How do you report on-call ER services?


Many a time, physicians tend to patients in the emergency department while on call. You don't need to turn to the after-hours codes to bill for these services when the hospital pays your physician for on-call status.


If the ...
... hospital is already paying the physician to be the on-call physician in the emergency room, you cannot double-bill for his services. Here you should bill the after-hours codes 99050 and 99058.


Can you give billing a miss altogether?


If you are tempted to simply arrange a quid-proquo arrangement with other practices for your physicians to cover for one another at various times, you may be losing out on your reimbursements. Reciprocal billing works only for two practices that have similar size practices with similar patient make-ups (similar acuity) and whose doctors perform nearly equal coverage.


To avoid on-call fraud accusations and more insight on reciprocal billing, you can go for billing and collections seminars.


Gain knowledge about billing and collections conferences by attending proper Billing and collections seminars along with premier coding experts, CDs, tapes and transcripts of coding training information by specialty.