tci Medicare Compliance & Reimbursement - 2011 Issue 4
Reader Questions: You Can't Choose Not to Bill for Post-Surgical Care
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Article Overview
This article explains the billing, compliance, and documentation issues that can arise when a practice considers providing post-surgical care beyond the global period without charging the patient. It is aimed at medical coders, billing staff, and practice managers who handle surgical follow-up, payer compliance, and financial hardship policies. The discussion focuses on general global period concepts, federal compliance concerns, payer expectations, and documentation needed when a bill is written off for hardship reasons.
Why This Topic Matters
Policies for postoperative care affect claim accuracy, compliance exposure, and payer relationships. Understanding the limits on waiving charges helps practices avoid billing and documentation problems while still addressing patients who cannot pay.
What You Will Learn
- How global period billing relates to postoperative follow-up care
- Why waiving charges after a global period can raise compliance concerns
- What general options a practice may consider when a patient cannot pay
- What documentation is associated with financial hardship write-offs
Who Should Read This
- Medical coders
- Billing specialists
- Practice managers
- Physician office staff
- Compliance personnel
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