Physicians Practice - June 2008 - (Page 51) This is a benefit you offer out of the goodness of your heart and a desire to retain employees. If an employee doesn’t want it, so be it. THE GIFT OF HEALTH would prefer to take all the charts with me. I’m just moving to a different office in the same complex; most of the patients will follow me, I’m sure. • A different set of rules may apply when records are copied for attorneys or health plans. It is common to charge $30 to $50 per chart or a flat fee of $10 for up to 25 pages with a charge of 25 cents per page thereafter. • State laws and contractual agreements with managed care organizations (MCOs) may limit what a physician can charge for copying records. For example, workers’ compensation programs require extensive documentation as a condition of payment, and MCOs request patient records for medical review or to evaluate referral requests. NO-INTEREST CHARGES ON MEDICARE ACCOUNTS covered under Part B. The participant shall not collect from the beneficiary or other person or organization for covered services more than the applicable deductible and coinsurance.” See: http://www.cms.hhs.gov/ cmsforms/downloads/cms460.pdf TAKING CHARTS WHEN LEAVING A GROUP Q I’m leaving my current practice. What are the legalities regarding charts? There was no mention of this in the contract I signed with the group, and they really don’t care. Obviously, I A Generally, the group owns the charts, not the physician. Your current group does need to retain originals because they are liable for malpractice or billing issues that come up later on. In any circumstance, patients can request that a copy of their files be sent to you. What you might do is ask the group to copy charts for you only as patients come to you versus copying everything when you aren’t sure which patients will stay or go. You also should review this comprehensive article from the AAFP. Note that you need to advise patients that you are leaving. This gives them an opportunity to request a chart transfer: http://www.aafp.org/fpm/20051000/ 54amus.html Q I have searched online articles and appropriate Web sites, including CMS, but have been unable to find a definitive answer to this question: Is it legal (i.e., not violating conditions of participation) to charge interest on an outstanding balance in a Medicare beneficiary’s account? I have been told that charging interest on an outstanding balance violates the conditions of participation because a provider then ends up charging more than allowed by Medicare. Could you please clarify? A That is right. And it is stated right in the first paragraph of the Medicare participating physician agreement: “For purposes of this agreement, accepting assignment of the Medicare Part B payment means requesting direct Part B payment from the Medicare program. Under an assignment, the approved charge, determined by the Medicare carrier, shall be the full charge for the service WWW.PHYSICIANSPRACTICE.COM JUNE 2008 | PHYSICIANS PRACTICE | 51 http://www.cms.hhs.gov/cmsforms/downloads/cms460.pdf http://www.cms.hhs.gov/cmsforms/downloads/cms460.pdf http://www.aafp.org/fpm/20051000/54amus.html http://www.aafp.org/fpm/20051000/54amus.html http://merage.uci.edu http://merage.uci.edu http://WWW.PHYSICIANSPRACTICE.COM
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