Ama Policy

Hospital Billing on Behalf of Physicians H-385.939

Claims Filing Deadlines

Our AMA: (1) advocates that personnel performing diagnostic and procedural coding of physicians’ services provide that information, including itemized billing information, collection rates, procedures, and remittance information, to those physicians providing the coded services; (2) urges physicians to participate in the processes used by entities submitting claims for and receiving payment on behalf of physicians; (3) urges that any entity billing for physicians’ services ensure that, when a physician’s choice of CPTcode has been changed, the physician be so notified and the recoder identified before submission of a bill; (4) encourages physicians to carefully evaluate their billing procedures upon selling their practice or contracting for billing services; (5) encourages physicians to establish billing practice policies and billing compliance programs that include monitoring and reviewing billing accuracy; and (6) encourages physicians who sell their practice or contract out billing services to establish a mechanism for continually reviewing the collection methods and procedures of the billing entity.

Policy Timeline

CMS Rep. 6, I-98 Reaffirmed: CMS Rep. 4, A-08 Reaffirmed: CMS Rep. 01, A-18