Physical Therapy and Medigap Plan N

[saintstigers]

If a client has the Plan N and has to undergo physical therapy visits. The Plan N should take care of the cost of the visits. It wouldn't be a $20 copay each visit right?

 

[goillini52]

If a client has the Plan N and has to undergo physical therapy visits. The Plan N should take care of the cost of the visits. It wouldn't be a $20 copay each visit right?

Correct...as long as it's not an office call.

 

[wehotex]

Correct...as long as it's not an office call.

So you mean $0 copayments?f

 

[G.Gordon]

I've seen both ways. Clients that have had a $20 per visit and those that have $0. If it is an official "office visit" then sure enough $20.

 

[cadylou]

All depends on how it's coded. There was an issue with this when Plan N first came out & I called the carrier & they told me specific billing codes to use that wouldn't result in the "office copay" being applied. . . .They need to watch their bills and/or ask in advance & spoon feed the proper billing codes if necessary.

 

[somarco]

http://www.insurance-forums.net/forum/senior-insurance-forum/when-plan-n-copay-applied-t78437.html

 

[MBSC]

From a previous thread on this subject:

Since plan N came along I have had a few people call me complaining about $20 copayments for physical therapy or chiropractic treatments. In each case the provider used a doctor office visit CPT code instead of the appropriate CPT code for that treatment, and in every case, after resubmitting the claim, the copayment went away.

Reference: http://www.insurance-forums.net/for...lan-n-physical-therapy-t70526.html#post927618

 

[WCMason]

All depends on how it's coded. There was an issue with this when Plan N first came out & I called the carrier & they told me specific billing codes to use that wouldn't result in the "office copay" being applied. . . .They need to watch their bills and/or ask in advance & spoon feed the proper billing codes if necessary.

So true. I had an upset Plan N client wanting out due to $20 copays on every chiropractic session. Instead the knucklehead biller was persuaded to submit the claims correctly. Copays vanished.