Practice Management

Hi Kim

In connection with the Provider Relief Fund payments, HHS stated on their website that they deem ALL patients to be possible COVID-19 patients...see  https://www.hhs.gov/provider-relief/index.html.  I'm saving a screen shot of that website in case there is a question down the road.

My reading is that you can't bill out of network patients more than they would have had to pay out of pocket if they were in-network.  No other constraints on balance billing, however.

Don't ask me how you're supposed to figure out what an out of network patient would owe out of pocket if in-network.  Since out of network was pretty rare for us before the crisis, and mostly people from out of town without a national network, I figure this will be exceedingly rare given low volume and limited travel now.  We'll probably just write them off if they come up.

Hope this helps!

Dave

------------------------------
David Smith FACMPE
Executive Director
United Imaging Consultants
Mission KS
(785) 393-8387
------------------------------

Original Message:
Sent: 04-21-2020 08:41
From: Kim Smiley
Subject: HHS Attestation

Hello,

I am hoping someone can answer this question for me...

 

It is my understanding, as part of the Attestation for the HHS money, providers can't balance bill COVID-19 patients. Does this only apply to services used in the diagnostic care of COVID-19 or does it apply to any services rendered during the entire episode of care for a COVID-19 patient?

 

Be Safe and Stay Well,  

 

Kim Smiley, CPC, RCC

Coding Manager

ph:  (317) 328-7256  |  fax: (317) 715-9955

kim@northwestradiology.com

 

 

Original Message------

Hi Kim

In connection with the Provider Relief Fund payments, HHS stated on their website that they deem ALL patients to be possible COVID-19 patients...see  https://www.hhs.gov/provider-relief/index.html.  I'm saving a screen shot of that website in case there is a question down the road.

My reading is that you can't bill out of network patients more than they would have had to pay out of pocket if they were in-network.  No other constraints on balance billing, however.

Don't ask me how you're supposed to figure out what an out of network patient would owe out of pocket if in-network.  Since out of network was pretty rare for us before the crisis, and mostly people from out of town without a national network, I figure this will be exceedingly rare given low volume and limited travel now.  We'll probably just write them off if they come up.

Hope this helps!

Dave

------------------------------
David Smith FACMPE
Executive Director
United Imaging Consultants
Mission KS
(785) 393-8387
------------------------------

Hi Rick

I don't believe there is any mandate for anyone to cover COVID-19 related treatment at 100%. That would take an act of Congress, which has not happened. Medicare is covering testing at 100%, and some private payors have voluntarily followed suit for their insured groups, but  that generally doesn't extend to self-insured groups who have to opt in or out.

There may be some state specific variations that I'm not aware of.

------------------------------
David Smith FACMPE
Executive Director
United Imaging Consultants
Mission KS
(785) 393-8387
------------------------------

Original Message:
Sent: 04-21-2020 10:05
From: Rick Sylvanus
Subject: HHS Attestation

I believe her question was whether full payment for COVID related services can be expected for just the diagnosis, or full ALL services performed subsequently. (Say, multiple CXR over several days during an inpatient admission.)

It was the same question I posted recently but nobody weighed in on it.

--

Rick Sylvanus

Operations Manager

Southern Delaware Imaging Associates

17503 Nassau Commons Blvd

Lewes, DE 19958

E-Mail: Rick@sdiassociates.com

Office: 302-645-7919 x201

Fax: 302-645-7841

 

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Original Message------

Hi Kim

In connection with the Provider Relief Fund payments, HHS stated on their website that they deem ALL patients to be possible COVID-19 patients...see  https://www.hhs.gov/provider-relief/index.html.  I'm saving a screen shot of that website in case there is a question down the road.

My reading is that you can't bill out of network patients more than they would have had to pay out of pocket if they were in-network.  No other constraints on balance billing, however.

Don't ask me how you're supposed to figure out what an out of network patient would owe out of pocket if in-network.  Since out of network was pretty rare for us before the crisis, and mostly people from out of town without a national network, I figure this will be exceedingly rare given low volume and limited travel now.  We'll probably just write them off if they come up.

Hope this helps!

Dave

------------------------------
David Smith FACMPE
Executive Director
United Imaging Consultants
Mission KS
(785) 393-8387
------------------------------

Original Message------

Hi Kim

In connection with the Provider Relief Fund payments, HHS stated on their website that they deem ALL patients to be possible COVID-19 patients...see  https://www.hhs.gov/provider-relief/index.html.  I'm saving a screen shot of that website in case there is a question down the road.

My reading is that you can't bill out of network patients more than they would have had to pay out of pocket if they were in-network.  No other constraints on balance billing, however.

Don't ask me how you're supposed to figure out what an out of network patient would owe out of pocket if in-network.  Since out of network was pretty rare for us before the crisis, and mostly people from out of town without a national network, I figure this will be exceedingly rare given low volume and limited travel now.  We'll probably just write them off if they come up.

Hope this helps!

Dave

------------------------------
David Smith FACMPE
Executive Director
United Imaging Consultants
Mission KS
(785) 393-8387
------------------------------