FAQs

Frequently Asked Questions

Can cash provider treat workers comp patient

Can a cash practice see a workers’ compensation patient?   Maybe.  State laws govern workers’ compensation.  If your state laws allow the employee to choose their heath care providers, versus allowing the employer to direct what providers see their injured workers, then you should be able to see the patient. State work comp laws may …

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Will working somewhere that requires me to enroll with Medicare cause issues for my cash practice?

Question:  I need to work at another private practice to supplement my income while building my cash practice.  The practice sees and bills Medicare under the practice’s NPI number.  They will require me to enroll as a Medicare provider to treat their patients. Will this cause any issues for my cash practice?  Will I have …

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Can my patient submit a claim to their supplemental insurance plan?

Q:  My patient has a Medicare Supplemental Insurance Plan.  She wants to know if she can submit her claims to the supplemental insurance plan without submitting to Medicare first. Should I give her a statement to submit? A:  Some supplemental plans may reimburse their insureds for medically necessary services provided by unenrolled providers without requiring …

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Medicare Rules for PT Benefits

Do you need to know what the rules are for getting PT, OT and other services covered under Medicare, including what all the billing, coding and documentation rules are?  The Medicare Benefit Policy Manual is where you need to look.  PT, OT and Speech policies are in section 220 of Chapter 15, available here.

Find your State Privacy Laws

State Privacy and Confidentiality Laws Whether you are a covered entity under HIPAA (cash practices who do not submit electronic billing transactions may not be), most states have privacy and confidentiality laws that still protect patients without regard to whether the provider bills electronically. Therefore, we recommend that providers become familiar with their state laws …

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