Auto Insurance Billing

[Guest guest]

I'm helping my mom go through her reams of medical bills from the past year and a half.  She was rear-ended in her car in January, 2010.  She saw her PCP 2-3 days after the accident when she wasn't starting to feel better.  She just got a bill (we don't know why the auto insurance has not yet paid other than we are still contending that we are not willing to settle because she is still having sx that started immediately after the accident).  Anyways, her PCP coded it as a " New Patient Office Visit. "   She had seen him within the previous year (2009) multiple times.  When I asked the billing department today (he outsources), she told me that he codes it as a new patient office visit because he creates an entirely separate chart for patients for WC and MVA's.  Now, I think it's totally stupid to do this on so many levels, but, my question is - can he charge it as a new patient visit?  My contention is not, but I would love to be enlightened because we never charge patients as a new patient office visit for WC or MVA (mainly because we keep only one chart per patient - electronically).  Obviously he has been billing this way and getting away with it for many years (and MVA's typically pay 100% of charges around here and a new patient is more than an existing patient visit).  If it's kosher to do this, we have been letting $100's slide past us every year.  But ethically, I do not think it's kosher.....would love to hear from some of you about this!

 

Thanks,

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Pratt

Oak Tree Internal Medicine, PC

2301 Camino Ramon, Suite 290

San Ramon, CA 94583

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www.prattmd.info