Q. Can practices charge a fee to complete individual disability income claims forms?
A. In general, you may charge a reasonable fee for providing a summary of a patient’s record information or to fill out forms or other services.
Note, however, that if the particular forms in question are for workers’ compensation, Texas law prohibits physicians from “charging or attempting to charge fees for required reports … to an injured worker for treatment of a compensable injury or illness.”
You also should consult your insurer contracts: There might be an insurance contract provision that addresses such fees. In addition, Medicare and Medicaid plans include actions such as filling out forms and making phone calls as part of the covered service.
Make sure your patient financial forms let you bill and collect for any noncovered services and that these are part of your written billing policies.
There is also an ethics dimension to consider. American Medical Association ethics opinion 1.1.1 states a physician should act as a patient’s advocate.
For more on this topic, see “Extra Fee, Extra Hassle: Charging Patients Extra Fees May Hurt, Not Help” (Texas Medicine, May 2013).
Have questions like this? Look for an answer, or ask your question on the TMA Knowledge Center FAQs page (TMA log-in required). We’ve collected some of most frequent FAQs in You’ve Got Questions? We Have Answers, available in the TMA Education Center.
NOTICE: The Texas Medical Association provides this information with the express understanding that (1) no attorney-client relationship exists, (2) neither TMA nor its attorneys are engaged in providing legal advice, and (3) the information is of a general character. This is not a substitute for the advice of an attorney. While every effort is made to ensure that content is complete, accurate, and timely, TMA cannot guarantee the accuracy and totality of the information contained in this publication and assumes no legal responsibility for loss or damages resulting from the use of this content. You should not rely on this information when dealing with personal legal matters; rather legal advice from retained legal counsel should be sought. Any legal forms are only provided for the use of physicians in consultation with their attorneys. Certain links provided with this information connect to websites maintained by third parties. TMA has no control over these websites or the information, goods, or services provided by third parties. TMA shall have no liability for any use or reliance by a user on these third-party websites.
Published Oct. 19, 2017
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