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tci ED Coding & Reimbursement Alert - 2000 Issue 12
Reader Question: Waiving of Coinsurance
Question: I know that Medicare considers the routine waiver of coinsurance or deductibles an unlawful practice. It is my understanding that this is also unlawful for other commercial payers. Can you refer me to a written resource? Jan Loomis, CPCTeamHealth West, Pleasanton, Calif.Answer: Technically, with all health plans, it would be violating the contract provisions between the patient/health plan and, if participating with that health plan, the group/health plan. The group signs an agreement to charge a patient for any deductible and co-pay. If the group does not, the actual fee was lower than reported on the claim...
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