巧立名目,這個東西的確大部分保險是不cover的,Medicare 也不cover

來源: 2022-07-12 09:04:13 [博客] [舊帖] [給我悄悄話] 本文已被閱讀:

現在這種巧立名目的東西太多。

你可以研究一下這段話: Medicare does not cover this visit for healthy, asymptomatic patients. Commercial payors, however, are required to provide coverage for this visit, which is considered a fundamental component of screening colonoscopy. So, if you incorporate these visits in your practice, you should get paid for them. Some Blue Cross/Blue Shield plans require a Healthcare Common Procedure Coding System (HCPCS) code for this (S0285); others will use a code for an office visit or even a preventive service code, like the 99401 series. Keep an eye on payments to be sure the commercial payors are covering these consultations in full.