Pos Meaning Medical Billing

22 on campus outpatient hospital a portion of a hospital s main campus which provides diagnostic.

Pos meaning medical billing. More than half of the states have enacted legislation to protect consumers from balance billing in emergency situations and in situations where the patient unknowingly receives treatment from an out of network provider while at an in network. Place of service code s place of service name place of service description. A pos health plan stands for point of service and is a mix between an hmo and a ppo style health insurance policy. Pos 21 inpatient hospital.

Place of service code 21 is a 2 digit code 21 used on professional claims hcfa 1500 form on block 24b to specify an inpatient hospital were rendered. A pos point of service health insurance plan is one of the big three managed care plans along with ppo preferred provider organizations and hmo health maintenance organizations. Pos is point of service plan. With a pos health plan you have more choices than with an hmo.

This is called balance billing. Point of service pos medical terms for billing and coding aapc point of service pos an additional mandatory supplemental or optional supplemental benefit that allows the enrollee the option of receiving specified services outside of the plan s provider network. When a non hmo specialist is seen without referral from the primary care physician self referral they have to pay a higher deductible and a percentage of the coinsurance typically 20 to 30. Effective october 1 2003 02.

Pharmacy a facility or location where drugs and other medically related items and services are sold dispensed or otherwise provided directly to patients. Place of service 21 is facility or location which provides health care services to patients admitted for varieties of medical conditions. Even if your pos or ppo insurance pays a portion of the cost the medical provider can bill you for the difference between their regular charges and what your insurance pays. You may need to.

Suggest to this list. This place of service codes is a 2 digit numeric codes which is used on the hcfa 1500 claim form while billing the medical claims to the health care insurance companies denoting the place where the healthcare services was performed from the provider to the patient. This is a flexible type of hmo health maintenance organization plan where patients have the freedom to use or self refer to non hmo network providers.