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Dec 21st, 2016 - sschwartz 2 

Immigration physicals

Can anyone tell me who I am to bill an "Immigration Physical" to? There is a nine page document for the physical the provider had to complete but no information on it regarding who we are to send the claim to. It's from the department of homeland security but I am pretty sure I wouldn't bill them; also no address on it. The patient has Tricare due to her husband being active duty in our armed forces; would I bill them? Or would it be a self pay charge like a CDL physical?

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Dec 21st, 2016 - tconte 2 

re: Immigration physicals

You cannot bill any insurance company for Immigration Physicals. It is the patient's responsibility. There is usually a set amount ($200 or so) for this physical to be completed and the patient is told to bring this amount when they come for the physical. It covers the physical and PPD and routine blood work only. If any additional vaccines, testing or blood work is required or additional handling on the part of the office, hospital or lab this will be billed directly to the patient in addition to the $200 or so payment they brought with them.

The physicals can only be performed by a physician that has attended the course and is certified to complete both the form and physical. The CPT® 99450 is used (which has parameters that need to be met) with the Z02.89 ICD-10 code.

The patient is sent a letter explaining the amount they need to bring with them and what this will cover and any extra charges that may incur prior to the visit. The patient is made aware of the amount due when they schedule the appointment. It is usually cash or credit card, personal checks are usually never accepted for this type of physical.

Hope this helps.

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Dec 22nd, 2016 - LBAROGIANIS 249 

re: Immigration physicals

I would bill tricare like you would any other physical. If they don't pay then bill patient.

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Dec 27th, 2016 - tconte 2 

re: Immigration physicals

You cannot under any circumstances bill the insurance carrier for the Immigration Physicals. The payment is collected up front and the amount is decided upon according to the office. The physicals cannot be given by anyone but a certified provider that has completed the course and passed the exam. This is not like any other physical - the CPT® code is 99450. You cannot use any other CPT® code for this physical. Do not send up any unnecessary red flags by trying to bill the insurance companies. If the patient is informed ahead of time they will bring in the amount that you request and make sure you explain that this will cover only part of what is needed should the exam become more extensive.

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