Hi
Currently working for a group Practice that accepts most insurances. A cash only healthcare Practice has offered employment under their tax ID. They accept cash only in the disclaimer and in their consent documentation they clearly emphasize that the doctors may be working for other companies or the other locations that take insurances, however, when they're employed under the services of this cash only practice no insurance is accepted and the payment is cash only
I wasn't sure this was possible if you're credentialed and participating with multiple health insurance plans, can you work for a company that accepts cash only under their tax ID? In particular, I was interested in the big three insurances and Medicare.
Thank in advance for any insights on this matter.
I would try to get a list of health care attnys from your professional liability (malpractice) contractor.
The key for you to remembe is that you are not working for yourself but for a group when you work for and are billing under a group's tax ID.
Just because he has a cash price list, and does not participate with any insurance company may work for non Medicare.
I would ask him if he has opted out of Medicare.
If he has not opted out of Medicare and is charging a fee if that fee is above the 125% non par allowed fee that is problematic. If he has opted out of Medicare, he can charge whatever he wants.
How this effects you is the key ? because you certainly don't want to opt out.
Good luck!
Thank you very much! That was very helpful. This particular provider doesn't participate in any insurance program including medicare. Strangely, he has a menu with all his services and the cash price listed on the registration form. He prints out a receipt and hands it over to the pt almost like a restaurant.
I'm used to working in my office and I participate with all the insurances so this felt strange to me.
I didn't think you could practice by collecting a fee and have a price list like that. Is there a site that podiatrists use to get reputable healthcare attorneys for consulting for things like this or do we kind of just use google?
As always, I speak for most readers who really appreciate your insights on these things.
I will only provide thoughts here for you to review with a health care attorney.
A
For private insurance, there is nothing inherently wrong with this arrangement so long as any bill which the patient requests be sent to the carriere be sent under the groups Tax ID as it is the group which is billing the care if you are acting as a employee of the group.
As for Medicare this is a bit stickier and I think it best you run this by a health care attorney prior to acting on this. Some of the issues to deal with are you or the group acting as non-par and having the patients pay. But remember, there are limiting charges regarding the maximum you can charge. Or under the auspices of the group are you acting as an opt out, which leaves the patient almost no recourse to collect payment. This latter course may be problematic and if it is possible, a health care attorney should assist you with some explanations and assistance with your contract.