99051 billing

Billing & Coding
1

Does anyone have a sample policy that they have a parent sign to acknowledge an additional fee for the 99051?

In our practice, we have tried to add it for federal holiday or our Saturday hours that are regularly scheduled and NEVER get it paid by anyone. So, what happens is our office manager who oversees our Athena billing then writes it off and says it is taking valuable time and we stop. When we have tried to have patients pay it, there is lots of push back to which again the office caves. I have leaving this on the table when in fact I have to give up being home with my school age kids on a federal holiday they are home as do my MAs because we can be very busy on those days. Looking for some verb-age that we can use to establish this as an expectation when patients schedule on these days.
Thanks! Sharon Novy
Children’s Oasis Peds in Gilbert, AZ
(this has resurfaced after I listened to the complimentary coding seminar from the recent PMI conference!)

2

We get paid by most insurance plans. Parents do not sign a waiver and we kindly explain that we are open on Saturdays and holidays so our patients don’t have to utilize U/C’s or E/R’s which is far more expensive then the charge for 99051. Insurance companies, AAP, CMA and AMA all agree that it is a fair and reasonable charge and appreciate offices who stay open on weekends, holidays and who have extended hours because it saves money. We cannot write it off because we are contracted with carriers to bill patients for balances that they deem are the patient’s responsibility (deductible, copay and coinsurance).