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family practice billing urgent visit


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I work in a family practice that takes appointments and walkin.  A large number of walk ins.  One of the providers had brought her daughter for a sick visit but did not have an appointment.  They have insurance but got an EOB that showed the insurance was being billed for an urgent visit to the tune of $300.  When checking why it was billed that way she was told that all the walk ins are billed that way.  Not really much urgent about the "sniffles".

Just wondering if this legal?  We are a family practice NOT an urgent care.

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Probably not. There are specific rules about billing urgent care fees and generally they do not allow for a private practice to bill urgent care during regular business hours. I would advise the billing folks to re-read the rules and be very, very sure they are in the right here.

And seriously...it doesn't look good that one of the providers is the first to notice this practice.

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