Re: Medicare Wisdom? -- prompt pay discount

[Guest guest]



Yes, I discount prompt pay discount 10% off day of service.

My billing company suggested this.

Bigger issues:

1) I was able to identify 2 classes of states --

A) Medicare is WORST payor -- Pennsylvania (at least western PA where I am), commercial payors pay 10-20% OVER Medicare.

Medicare is BEST payor -- California, NJ, NY by report of some listservers; commercial payors pay 60-70% OF Medicare.

2) I will charge through to high deductible pts the full deductible but GIVE THEM 10% off total bill when they pay at the time of service.

This works better for me.

Also, get a merchant credit card terminal, so you don't have to go after debtors -- the credit card company does!

Hope this helps!

Dr Matt Levin, Fam Med

Solo in Western PA

matlev@...

Email me if want more info

Re: Medicare Wisdom?

I've specifically looked into this. You can charge a "prompt-pay" discount, or a cash fee that is less than Medicare, the same for all patients. The assumption is that

If you par with Medicare, you MUST NOT charge Medicare patients more than other patients. Therefore, if the allowable charge for Medicare for a particular code is, for example $75, you must charge your cash pay patients $75 and that is after any discounts.

You can bill whatever you want, medicare will pay you what they pay you. Giving a same day pay discount is fair game. I use OfficeAlly for EHR and billing. Billing is free and I have had 100% reimbursement.Good luck with your new practice

Greetings to all.I'm opening my house-call only IMP next month and am grateful for the many things I've learned from you all. I now have an important question regarding Medicare.I am planning starting this practice as I continue working at an urgent care job that I like very much. I also plan my practice to be direct-pay (cash-only), but because I take Medicare at the urgent care job, I can not see Medicare patients in my practice on a cash-only basis. Many Medicare patients in my community would benefit from the type of service I want to provide, and I am exploring the option of accepting Medicare in my practice, but doing cash only for all other patients. My questions for this group are as follows…1. Where can I learn about the pitfalls about what I charge cash-pay patients when I also accept Medicare assignment? (Ex. Can I charge a Medicare patient more than what I charge a cash-pay patient or do I need to set a fee similar to the Medicare fee and then give a pay-at-time-of-service discount?)2. Recommendation on an easy/inexpensive way of doing electronic claims submission?3. Is there anyone on the list who has such a practice structure? Please feel free to contact me offline.4. Am I crazy? No professional opinions please.Thanks,Jack

-- M.D.www.elainemd.comOffice: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above. If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error.

[Guest guest]

I just opened my practice and was wondering about this very issue with those

with high deductibles. Are any potential problems with billing insurance one

fee towards the deductible, but not collecting what you billed? I'd like to be

able to do this to help out my patients but I worry that I might run into

trouble.

Dave Ou, M.D.

Atlanta, GA

>

>

> Greetings to all.

> I'm opening my house-call only IMP next month and am grateful for the

many things I've learned from you all. I now have an important question

regarding Medicare.

>

> I am planning starting this practice as I continue working at an

urgent care job that I like very much. I also plan my practice to be direct-pay

(cash-only), but because I take Medicare at the urgent care job, I can not see

Medicare patients in my practice on a cash-only basis. Many Medicare patients in

my community would benefit from the type of service I want to provide, and I am

exploring the option of accepting Medicare in my practice, but doing cash only

for all other patients.

>

> My questions for this group are as follows…

> 1. Where can I learn about the pitfalls about what I charge cash-pay

patients when I also accept Medicare assignment? (Ex. Can I charge a Medicare

patient more than what I charge a cash-pay patient or do I need to set a fee

similar to the Medicare fee and then give a pay-at-time-of-service discount?)

> 2. Recommendation on an easy/inexpensive way of doing electronic

claims submission?

> 3. Is there anyone on the list who has such a practice structure?

Please feel free to contact me offline.

> 4. Am I crazy? No professional opinions please.

>

> Thanks,

> Jack

>

>

>

>

>

>

> --

> M.D.

> www.elainemd.com

> Office:

> Go in the directions of your dreams and live the life you've imagined.

> This email transmission may contain protected and privileged, highly

confidential medical, Personal and Health Information (PHI) and/or legal

information. The information is intended only for the use of the individual or

entity named above.

>

>

>

> If you are not the intended recipient of this material, you may not use,

publish, discuss, disseminate or otherwise distribute it. If you are not the

intended recipient, or if you have received this transmission in error, please

notify the sender immediately and confidentially destroy the information that

email in error.

>

[Guest guest]

Hi Dave Welcome and  congrats on openingYes you could get into some trouble unless you can give a discount that is clearly based on  he reason you give it-- pay at time of service, get X % off ,the  X%  saving you the cost of billing

 Be careful also about trying to save the world(  trying to protect people from paying) on your back You have to pay your  own bills! But you do have a contract with insurers. If you bill for 120.00 and the patient owes it all you are supposed to collect it.

Jean

Hey dave coming to  our annual confernce in 2mo in Denver? There  would  be lots of good helpful stuff for you. go to    idealhealthnetwork.org and check out cme and also membership- join our monthly calls /get cme /

 and community!Jean

 

I just opened my practice and was wondering about this very issue with those with high deductibles. Are any potential problems with billing insurance one fee towards the deductible, but not collecting what you billed? I'd like to be able to do this to help out my patients but I worry that I might run into trouble.

Dave Ou, M.D.

Atlanta, GA

>

>

> Greetings to all.

> I'm opening my house-call only IMP next month and am grateful for the many things I've learned from you all. I now have an important question regarding Medicare.

>

> I am planning starting this practice as I continue working at an urgent care job that I like very much. I also plan my practice to be direct-pay (cash-only), but because I take Medicare at the urgent care job, I can not see Medicare patients in my practice on a cash-only basis. Many Medicare patients in my community would benefit from the type of service I want to provide, and I am exploring the option of accepting Medicare in my practice, but doing cash only for all other patients.

>

> My questions for this group are as follows…

> 1. Where can I learn about the pitfalls about what I charge cash-pay patients when I also accept Medicare assignment? (Ex. Can I charge a Medicare patient more than what I charge a cash-pay patient or do I need to set a fee similar to the Medicare fee and then give a pay-at-time-of-service discount?)

> 2. Recommendation on an easy/inexpensive way of doing electronic claims submission?

> 3. Is there anyone on the list who has such a practice structure? Please feel free to contact me offline.

> 4. Am I crazy? No professional opinions please.

>

> Thanks,

> Jack

>

>

>

>

>

>

> --

> M.D.

> www.elainemd.com

> Office:

> Go in the directions of your dreams and live the life you've imagined.

> This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above.

>

>

>

> If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error.

>

-- PATIENTS-please remember  that email may not be entirely secure, and that Email is part of the medical  record and is placed into your  chart ( be careful what you say!)

Email is best used for appointment making and  brief  questionsEmail replies can be expected within 24 hours-Please CALL  if the  matter is more urgent .     MD    

     ph    fax impcenter.org

[Guest guest]

So I am still confusedIs it ok to collect deductible and co insurance at the time of visit before eob is recieved?

Noe I am confusedIt is OK to charge patient's credit card, probable deductible

but NOT ok to keep credit card, to charge in future when EOB arrives and confirms credit card amount

 

BCBS of MI just changed their contract to not allow practices to hold credit card numbers for future billing. I hope this doesn't spread to other insurances and other states and I hope BCBS drops it in the future. Unfortunatley, I suspect the opposite will be true. Craig

> > >

> > >

> > > Greetings to all.

> > > I'm opening my house-call only IMP next month and am grateful for the

> > many things I've learned from you all. I now have an important question

> > regarding Medicare.

> > >

> > > I am planning starting this practice as I continue working at an urgent

> > care job that I like very much. I also plan my practice to be direct-pay

> > (cash-only), but because I take Medicare at the urgent care job, I can not

> > see Medicare patients in my practice on a cash-only basis. Many Medicare

> > patients in my community would benefit from the type of service I want to

> > provide, and I am exploring the option of accepting Medicare in my practice,

> > but doing cash only for all other patients.

> > >

> > > My questions for this group are as follows…

> >

> > > 1. Where can I learn about the pitfalls about what I charge cash-pay

> > patients when I also accept Medicare assignment? (Ex. Can I charge a

> > Medicare patient more than what I charge a cash-pay patient or do I need to

> > set a fee similar to the Medicare fee and then give a pay-at-time-of-service

> > discount?)

> > > 2. Recommendation on an easy/inexpensive way of doing electronic claims

> > submission?

> > > 3. Is there anyone on the list who has such a practice structure? Please

> > feel free to contact me offline.

> > > 4. Am I crazy? No professional opinions please.

> > >

> > > Thanks,

> > > Jack

> > >

> > >

> > >

> > >

> > >

> > >

> > > --

> > > M.D.

> > > www.elainemd.com

> > > Office:

> > > Go in the directions of your dreams and live the life you've imagined.

> > > This email transmission may contain protected and privileged, highly

> > confidential medical, Personal and Health Information (PHI) and/or legal

> > information. The information is intended only for the use of the individual

> > or entity named above.

> > >

> > >

> > >

> > > If you are not the intended recipient of this material, you may not use,

> > publish, discuss, disseminate or otherwise distribute it. If you are not the

> > intended recipient, or if you have received this transmission in error,

> > please notify the sender immediately and confidentially destroy the

> > information that email in error.

> > >

> >

> >

> >

>

>

>

> --

> M.D.

> www.elainemd.com

> Office:

> Go in the directions of your dreams and live the life you've imagined.

> This email transmission may contain protected and privileged, highly

> confidential medical, Personal and Health Information (PHI) and/or legal

> information. The information is intended only for the use of the individual

> or entity named above.

>

>

>

> If you are not the intended recipient of this material, you may not use,

> publish, discuss, disseminate or otherwise distribute it. If you are not the

> intended recipient, or if you have received this transmission in error,

> please notify the sender immediately and confidentially destroy the

> information that email in error.

>

-- Sangeetha Murthy M.D

-- Sangeetha Murthy M.D

[Guest guest]

If they don’t have secondary  insurance and you know for sure

their deductible hasn’t been met and what their co-pay will be, then “yesâ€.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From:

[mailto: ] On Behalf Of Sangeetha

Murthy

Sent: Thursday, August 19, 2010 10:41 PM

To:

Subject: Re: Re: Medicare Wisdom? -- prompt pay

discount

So I am still confused

Is it ok to collect deductible

and co insurance at the time of visit before eob is recieved?

On Wed, Aug 18, 2010 at 9:22 AM, Sangeetha Murthy

wrote:

Noe I am confused

It is OK to charge patient's credit card, probable

deductible

but NOT ok to keep credit card, to charge in future when EOB

arrives and confirms credit card amount

BCBS of MI just changed their contract to not allow

practices to hold credit card numbers for future billing. I hope this doesn't

spread to other insurances and other states and I hope BCBS drops it in the

future. Unfortunatley, I suspect the opposite will be true. Craig

> > >

> > >

> > > Greetings to all.

> > > I'm opening my house-call only IMP next month and am grateful

for the

> > many things I've learned from you all. I now have an important

question

> > regarding Medicare.

> > >

> > > I am planning starting this practice as I continue working at an

urgent

> > care job that I like very much. I also plan my practice to be

direct-pay

> > (cash-only), but because I take Medicare at the urgent care job, I

can not

> > see Medicare patients in my practice on a cash-only basis. Many

Medicare

> > patients in my community would benefit from the type of service I

want to

> > provide, and I am exploring the option of accepting Medicare in my practice,

> > but doing cash only for all other patients.

> > >

> > > My questions for this group are as follows…

> >

> > > 1. Where can I learn about the pitfalls about what I charge

cash-pay

> > patients when I also accept Medicare assignment? (Ex. Can I charge a

> > Medicare patient more than what I charge a cash-pay patient or do I

need to

> > set a fee similar to the Medicare fee and then give a

pay-at-time-of-service

> > discount?)

> > > 2. Recommendation on an easy/inexpensive way of doing electronic

claims

> > submission?

> > > 3. Is there anyone on the list who has such a practice

structure? Please

> > feel free to contact me offline.

> > > 4. Am I crazy? No professional opinions please.

> > >

> > > Thanks,

> > > Jack

> > >

> > >

> > >

> > >

> > >

> > >

> > > --

> > > M.D.

> > > www.elainemd.com

> > > Office:

> > > Go in the directions of your dreams and live the life you've

imagined.

> > > This email transmission may contain protected and privileged,

highly

> > confidential medical, Personal and Health Information (PHI) and/or

legal

> > information. The information is intended only for the use of the

individual

> > or entity named above.

> > >

> > >

> > >

> > > If you are not the intended recipient of this material, you may

not use,

> > publish, discuss, disseminate or otherwise distribute it. If you are

not the

> > intended recipient, or if you have received this transmission in

error,

> > please notify the sender immediately and confidentially destroy the

> > information that email in error.

> > >

> >

> >

> >

>

>

>

> --

> M.D.

> www.elainemd.com

> Office:

> Go in the directions of your dreams and live the life you've imagined.

> This email transmission may contain protected and privileged, highly

> confidential medical, Personal and Health Information (PHI) and/or legal

> information. The information is intended only for the use of the

individual

> or entity named above.

>

>

>

> If you are not the intended recipient of this material, you may not use,

> publish, discuss, disseminate or otherwise distribute it. If you are not

the

> intended recipient, or if you have received this transmission in error,

> please notify the sender immediately and confidentially destroy the

> information that email in error.

>

--

Sangeetha Murthy M.D

--

Sangeetha Murthy M.D

[Guest guest]

Huh.  I don’t know that that clause

is legal or would stand up in court?  I’d request to line item that one

out, myself. 

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From: [mailto: ] On Behalf Of Craig Ross

Sent: Wednesday, August 18, 2010

9:04 AM

To:

Subject:

Re: Medicare Wisdom? -- prompt pay discount

BCBS of MI just changed their contract to not allow

practices to hold credit card numbers for future billing. I hope this doesn't

spread to other insurances and other states and I hope BCBS drops it in the

future. Unfortunatley, I suspect the opposite will be true. Craig

> > >

> > >

> > > Greetings to all.

> > > I'm opening my house-call only IMP next month and am grateful

for the

> > many things I've learned from you all. I now have an important

question

> > regarding Medicare.

> > >

> > > I am planning starting this practice as I continue working at an

urgent

> > care job that I like very much. I also plan my practice to be

direct-pay

> > (cash-only), but because I take Medicare at the urgent care job, I

can not

> > see Medicare patients in my practice on a cash-only basis. Many

Medicare

> > patients in my community would benefit from the type of service I

want to

> > provide, and I am exploring the option of accepting Medicare in my

practice,

> > but doing cash only for all other patients.

> > >

> > > My questions for this group are as follows…

> >

> > > 1. Where can I learn about the pitfalls about what I charge

cash-pay

> > patients when I also accept Medicare assignment? (Ex. Can I charge a

> > Medicare patient more than what I charge a cash-pay patient or do I

need to

> > set a fee similar to the Medicare fee and then give a

pay-at-time-of-service

> > discount?)

> > > 2. Recommendation on an easy/inexpensive way of doing electronic

claims

> > submission?

> > > 3. Is there anyone on the list who has such a practice

structure? Please

> > feel free to contact me offline.

> > > 4. Am I crazy? No professional opinions please.

> > >

> > > Thanks,

> > > Jack

> > >

> > >

> > >

> > >

> > >

> > >

> > > --

> > > M.D.

> > > www.elainemd.com

> > > Office:

> > > Go in the directions of your dreams and live the life you've

imagined.

> > > This email transmission may contain protected and privileged,

highly

> > confidential medical, Personal and Health Information (PHI) and/or

legal

> > information. The information is intended only for the use of the

individual

> > or entity named above.

> > >

> > >

> > >

> > > If you are not the intended recipient of this material, you may

not use,

> > publish, discuss, disseminate or otherwise distribute it. If you are

not the

> > intended recipient, or if you have received this transmission in

error,

> > please notify the sender immediately and confidentially destroy the

> > information that email in error.

> > >

> >

> >

> >

>

>

>

> --

> M.D.

> www.elainemd.com

> Office:

> Go in the directions of your dreams and live the life you've imagined.

> This email transmission may contain protected and privileged, highly

> confidential medical, Personal and Health Information (PHI) and/or legal

> information. The information is intended only for the use of the

individual

> or entity named above.

>

>

>

> If you are not the intended recipient of this material, you may not use,

> publish, discuss, disseminate or otherwise distribute it. If you are not

the

> intended recipient, or if you have received this transmission in error,

> please notify the sender immediately and confidentially destroy the

> information that email in error.

>

[Guest guest]

,

I errored. The statement says that a practice can't " require " the patient leave

credit card info. The practice can request the info and the patient can leave

if they want. Sorry for the confusion.

Craig

> > > >

> > > >

> > > > Greetings to all.

> > > > I'm opening my house-call only IMP next month and am grateful for the

> > > many things I've learned from you all. I now have an important question

> > > regarding Medicare.

> > > >

> > > > I am planning starting this practice as I continue working at an urgent

> > > care job that I like very much. I also plan my practice to be direct-pay

> > > (cash-only), but because I take Medicare at the urgent care job, I can not

> > > see Medicare patients in my practice on a cash-only basis. Many Medicare

> > > patients in my community would benefit from the type of service I want to

> > > provide, and I am exploring the option of accepting Medicare in my

practice,

> > > but doing cash only for all other patients.

> > > >

> > > > My questions for this group are as follows…

> > >

> > > > 1. Where can I learn about the pitfalls about what I charge cash-pay

> > > patients when I also accept Medicare assignment? (Ex. Can I charge a

> > > Medicare patient more than what I charge a cash-pay patient or do I need

to

> > > set a fee similar to the Medicare fee and then give a

pay-at-time-of-service

> > > discount?)

> > > > 2. Recommendation on an easy/inexpensive way of doing electronic claims

> > > submission?

> > > > 3. Is there anyone on the list who has such a practice structure? Please

> > > feel free to contact me offline.

> > > > 4. Am I crazy? No professional opinions please.

> > > >

> > > > Thanks,

> > > > Jack

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > --

> > > > M.D.

> > > > www.elainemd.com

> > > > Office:

> > > > Go in the directions of your dreams and live the life you've imagined.

> > > > This email transmission may contain protected and privileged, highly

> > > confidential medical, Personal and Health Information (PHI) and/or legal

> > > information. The information is intended only for the use of the

individual

> > > or entity named above.

> > > >

> > > >

> > > >

> > > > If you are not the intended recipient of this material, you may not use,

> > > publish, discuss, disseminate or otherwise distribute it. If you are not

the

> > > intended recipient, or if you have received this transmission in error,

> > > please notify the sender immediately and confidentially destroy the

> > > information that email in error.

> > > >

> > >

> > >

> > >

> >

> >

> >

> > --

> > M.D.

> > www.elainemd.com

> > Office:

> > Go in the directions of your dreams and live the life you've imagined.

> > This email transmission may contain protected and privileged, highly

> > confidential medical, Personal and Health Information (PHI) and/or legal

> > information. The information is intended only for the use of the individual

> > or entity named above.

> >

> >

> >

> > If you are not the intended recipient of this material, you may not use,

> > publish, discuss, disseminate or otherwise distribute it. If you are not the

> > intended recipient, or if you have received this transmission in error,

> > please notify the sender immediately and confidentially destroy the

> > information that email in error.

> >

>

[Guest guest]

Does this apply to non-participating physicians also?

Dave

Dave Ou, M.D.

Atlanta, GA

> > > >

> > > >

> > > > Greetings to all.

> > > > I'm opening my house-call only IMP next month and am grateful for the

> > > many things I've learned from you all. I now have an important question

> > > regarding Medicare.

> > > >

> > > > I am planning starting this practice as I continue working at an urgent

> > > care job that I like very much. I also plan my practice to be direct-pay

> > > (cash-only), but because I take Medicare at the urgent care job, I can not

> > > see Medicare patients in my practice on a cash-only basis. Many Medicare

> > > patients in my community would benefit from the type of service I want to

> > > provide, and I am exploring the option of accepting Medicare in my

practice,

> > > but doing cash only for all other patients.

> > > >

> > > > My questions for this group are as follows…

> > >

> > > > 1. Where can I learn about the pitfalls about what I charge cash-pay

> > > patients when I also accept Medicare assignment? (Ex. Can I charge a

> > > Medicare patient more than what I charge a cash-pay patient or do I need

to

> > > set a fee similar to the Medicare fee and then give a

pay-at-time-of-service

> > > discount?)

> > > > 2. Recommendation on an easy/inexpensive way of doing electronic claims

> > > submission?

> > > > 3. Is there anyone on the list who has such a practice structure? Please

> > > feel free to contact me offline.

> > > > 4. Am I crazy? No professional opinions please.

> > > >

> > > > Thanks,

> > > > Jack

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > --

> > > > M.D.

> > > > www.elainemd.com

> > > > Office:

> > > > Go in the directions of your dreams and live the life you've imagined.

> > > > This email transmission may contain protected and privileged, highly

> > > confidential medical, Personal and Health Information (PHI) and/or legal

> > > information. The information is intended only for the use of the

individual

> > > or entity named above.

> > > >

> > > >

> > > >

> > > > If you are not the intended recipient of this material, you may not use,

> > > publish, discuss, disseminate or otherwise distribute it. If you are not

the

> > > intended recipient, or if you have received this transmission in error,

> > > please notify the sender immediately and confidentially destroy the

> > > information that email in error.

> > > >

> > >

> > >

> > >

> >

> >

> >

> > --

> > M.D.

> > www.elainemd.com

> > Office:

> > Go in the directions of your dreams and live the life you've imagined.

> > This email transmission may contain protected and privileged, highly

> > confidential medical, Personal and Health Information (PHI) and/or legal

> > information. The information is intended only for the use of the individual

> > or entity named above.

> >

> >

> >

> > If you are not the intended recipient of this material, you may not use,

> > publish, discuss, disseminate or otherwise distribute it. If you are not the

> > intended recipient, or if you have received this transmission in error,

> > please notify the sender immediately and confidentially destroy the

> > information that email in error.

> >

>

>

> --

> Sangeetha Murthy M.D

>

>

>

> --

> Sangeetha Murthy M.D

>