Billing self pay patients in global period.

Quote:

Our office manager is wanting to bill patients who do not have insurance for standard follow up care while they are in a global period. She states that she believes that global periods are carrier specific. And since the patient does not have insurance we can therefore bill them for all their follow up care. I'm trying to find somewhere where I can show her that global periods are not carrier specific they are AMA based. Can anyone point me in the right direction. I've found some helpful information on here, but I'm looking for something that kind of explains it in black and white terms. That's the only way she will understand. Any help you can give would be fantastic! Thank you!

In your AMA CPT book at the beginning of the surgical section they define the post operative global. Having said that. A surgical fee in your fee schedule consists of three separate segments, the pre op, the surgery, and the post op. Therefore if she wants to break it out for self pay they the fee schedule needs to represent this breakdown, so you will need to reflect all three segments, normally 10-15% of the global fee is for pre op! while 75-80% is surgery! and 10% is post op. That is not 10% for each encounter! that is 10% for the entire post op timeframe. So if it is a 90 day global the you take the global surgical fee and multiply by .10. (10%) and the divide by 90 and that is the per day fee.



Billing self pay patients in global period.