Frequently Asked Questions

The Billing Office, Inc. has prepared a list of questions that we are frequently asked.

Do we have to collect every co-payment?
Absolutely!! You are bound by OIG laws and regulations as well as private contractual obligations to collect co-pays. Routine failure to collect co-pays is a violation of the False Claims Act.

What about collecting co-pays and deductibles for Medicare and Medicare HMOs?
Collection of Medicare and Medicare HMO co-pays and deductibles is extremely important. Failure to regularly collect co-pays is considered “unlawful” because it results in violation of the False Claims Act

What are the penalties for routinely waiving Medicare and Medicaid co-pays and deductibles?
Routinely waiving Medicare and Medicaid co-pays and deductibles can result in criminal, civil, or administrative liability for making “false statements and/or submitting false claims.” Penalties are steep and can include imprisonment, criminal fines, civil damages, forfeitures of the provider’s practice and assets, civil monetary penalties, and exclusion for Medicare and Medicaid programs.

Are there any circumstances where a Medicare/Medicaid co-pay or deductible can be waived legally?
Yes, for financial hardship of a particular patient. This waiver should be used only occasionally. The patient should complete a form regarding their financial status. The provider or officer manager should sign the form and submit it with the billing information. A copy of the form can be downloaded from our FORMS section.

Why won’t you accept a Superbill/Charge Sheet that is missing information?
Unfortunately, we cannot assume on your behalf what services you might have performed. Filing a claim based on “assumed information” is considered fraud.