Forum - Questions & Answers

Mar 27th, 2015 - dburd 1 

Office Visits

Is there a limit on how many times a patient can be seen in a month and billed to Medicare ? Patient insists ion being seen nearly every other day. Please help.

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Mar 27th, 2015 - Jsmith201400 25 

re: Office Visits

That is a good question and I do not see a specfic number anywhere on the CMS website. It may be helpful to have the patient complete an ABN form after you have notified them that Medicare may not pay for the visit and the cost of the visit. In this case if Medicare does not pay for the visit, you have informed the patient ahead of time and they are responsible for the visit. Just a thought.
http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&script_id=191

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Mar 27th, 2015 - ladyt 10 

re: Office Visits

I have to agree with Jsmith - The ABN will protect the practice for reimbursement if MDCR decides the visit is pt responsibility. Remember the overarching element: is it medically necessary

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Mar 27th, 2015 - jvosfernea 66 

re: Office Visits

[I have to agree with Jsmith - The ABN will protect the practice for reimbursement if MDCR decides the visit is pt responsibility. Remember the overarching element: is it medically necessary]

I would also suggest this information be a part of a 'sit-down' with a Clt/Pt that is showing up insisting on being seen "nearly every other day".

Perhaps if they can either bring a more comprehensive 'basket of information' to the session with a provider (as in: writing a list of all concerns, to be reviewed when seen) then the session might be a more fruitful mtg for all?

OR, in the case of someone whose needs might be more psychological in nature (needing reassurance, hypochondria-based, etc?), the awareness that they will be financing additional sessions from their own pocket might be a mitigating factor toward whether or not they show up again "the day after tomorrow"??

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Mar 27th, 2015 - LBAROGIANIS 250 

re: Office Visits

The patient is just lonely. Does this patient have any relatives? Ask them to come in with her on her next appointment and gently have the doctor explained what is going on. Kind intervention needed.

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