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Let's say that I am a PCP, and one of my patients has a high deductible (say, $5,000) insurance plan (HDP). If I assess their symptoms as having a 99212 level complexity, and their insurer pays $25 for a 99212, do I have to take the $25 (which will be coming from the patient of the HDP) or can I charge an amount different than what the insurer reimburses for a 99212, since the insurance company is not paying?
Note: all numbers were totally made up, and probably are not even close to what real world numbers look like. I picked them for simplicity and sake of argument, as I am trying to understand the fundamentals of reimbursement, high-deductible insurance plans, and cash-only medicine.
Note: all numbers were totally made up, and probably are not even close to what real world numbers look like. I picked them for simplicity and sake of argument, as I am trying to understand the fundamentals of reimbursement, high-deductible insurance plans, and cash-only medicine.