Calls could cost you

New rules have been established that allow doctors to charge for telephone consultations in some circumstances. To be a billable call, the patient must not have been seen by the doctor for a week before the call or within 24 hours after the call. If the doctor provides services that could have happened at a regular office visit, then the doctor can submit a claim. The doctor must let the patient know the call isn't free and that he or she intends to bill.

Filing a claim

If the doctor does submit a claim to Humana, we'll treat it as if the doctor filed a claim for an office visit. So if your benefits have copayments for an office visit, you'd owe the doctor your copayment for an office visit. If your Humana plan has a deductible, we'll apply the allowable claims costs to your deductible. You'll pay the allowed charges, unless you've met your deductible.

These rules don't apply to most calls people make to their doctor. But Humana wants you to know that under current national rules, doctors can bill both Humana and their patients for some telephone visits.

Bottom line

It's important to know that calling your doctor could cost you in some circumstances. If you're aware of the rules, you could save yourself some money.

For more information:

American Academy of Pediatrics

For the Record