Can a service be billed if it is not clear that the physician performed a face-to-face encounter with the patient?

Billing for a service typically requires clear evidence that a face-to-face encounter took place between the physician and the patient. This is essential because many insurance providers, including Medicare, have specific requirements regarding the documentation and nature of the interaction that must substantiate the medical services billed. Without this clear documentation, it raises concerns regarding the legitimacy of the claim and adherence to compliance standards.

In cases where there is uncertainty about whether a face-to-face encounter occurred, billing may be denied. This is especially true for procedures and assessments which specifically require personal interaction rather than just telehealth services or documentation. Therefore, the absence of a confirmed face-to-face encounter means the service in question generally cannot be billed.

While some aspects of patient interaction, like telemedicine, may allow for certain services to be billed if proper documentation exists, uncertainty surrounding face-to-face encounters creates a compliance risk. Hence, without confirmation of a face-to-face encounter, billing is not permissible. This reflects the importance of thorough documentation and the need for providers to ensure they meet all billing requirements to avoid potential audits or claim denials.