Don’t Get Upset if You’re a Push Over

Don’t Get Upset if You’re a Push Over

This post was originally published on 2/20/2013

I never got angry when a patient asked for forms to be completed. I got paid, or at least tried to. I set a boundary.

You know the form, usually one you’ve never seen before: insurance forms, work physicals, disability forms, etc. Not the ones they schedule a visit for. At the end (or beginning) of a visit, they say, “Doc, can you fill out these form(s)?”

I’ve heard a couple of physicians complain about the horrible forms when we talk about the daily aggravations of practice. I’m happy to see the 16 year old for the driver’s physical, because getting them in is tough enough. But what if they bring the form in the week after you just did their physical? Do you grumble and complain, or do you just fill them out? Do you charge for them?

I never got upset. I used CPT Code 99080: “Special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form.”

What is your time worth and are you willing to collect payment for your time? I’ve read that sometimes people attach a time to the code, so say ten minutes. If a form takes more than that, they charge two units or however many multiples of ten minutes it takes.

My experience was that it was rarely reimbursed by insurance, so we adjusted the charge by the length of the form and how many. Short form, small charge. Long form, bigger charge. Multiple forms, multiples of the charge. Depends on how adaptable your billing system is. But there was always a charge.

And did I mention that if the form required more than a checkbox or two, I didn’t fill it out? You know those long forms that have a hundred checkboxes? I looked at the form, and did the work, documented it in my note, and my medical assistant filled out the form as I saw another patient. Then I signed it. My job is to do the work, not fill out check boxes that say I did the work.

Now if there was something the form needed, and it wasn’t in my note, and the patient wasn’t there, we brought them back. Because I did not say I did something that I didn’t actually do.

Setting boundaries isn’t easy. There are barriers like the emotional appeal from the patient, “Doc, c’mon, it’s just a form!” Our response, “I’m sorry, we have a charge for completion of forms. It just begins to pay us for the time spent taking care of your paperwork.” By the way, get paid before you hand over the form. Our fees weren’t that high, so chasing someone to get a minimal charge reimbursed when you’ve already handed them the form isn’t worth the time. So get it up front.

What about prior auth? Did they send you a form? Did you have a conversation about the insurer denying your requested medication? Did you document it? Those forms got a copy of my clinical note, with the note on the form that said, “See attached.” My note explained my rationale for whatever it was that I was requesting.

Here’s where your contract is important. If you signed that you will comply with prior auth requirements, check to see if you promised to do it at no charge. If they didn’t accept my, “See attached” they got billed for 99080.

So the simple choice is, would you rather get upset about filling out a form or get paid for doing it? You have the power to set that boundary. Don’t blame it on the patient.

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