Dr Fee for Filling Out FMLA HC Cert form

CPK

An employee went to the doctor multiple times resulting in the need for back surgery. The employee will be out awhile, thus completed the FMLA application. We gave the employee the HC cert form for the physician to complete during his next appointment. The employee pays the office visit co-pay and then learns he'll have to pay another $20 to have the physician complete the FMLA HC cert form.

Has anyone else heard of a separate fee for completing FMLA paperwork during an office/dr. visit? I haven't found anything in the regs allowing or prohibiting physicians to charge a fee to fill out a FMLA form. Or is this a case of simply bad physician - patient relations?

I'm tempted to approve FMLA without the cert form, but I don't want to this precedent for future FMLA requests. I've got different leave status to consider also.

Thanks for your comments.

ritaanz

There is nothing to stop a doctor's office from charging a patient for paper work. I have seen charges as high as $100 depending on the amount of information that is required.

Usually these doctor's are specialists in their particular area of expertise and could care less if someone goes to another physician because they do not wish to pay for the completion of forms.

NaeNae55

Agree with Rita. A doctor can charge for any services they want to, not just the ones the insurance companies will pay for.

This is the employee's responsibility, not the employer's. I understand some employers will foot the bill because they feel they should since they required the paperwork. We won't here as we see it as a dangerous precedent.

I would not simply skip the paperwork as this will tempt poor employees to fake fmla and simply claim the doctor wants $20 for the paperwork.

One more note: I remember reading about an employer who made a point to post a sign in their offices about a local doctor charging for FMLA paperwork. It was a small town and it worked. It got back to the doctor and he stopped charging the fee. Of course, it is easier to avoid if you know about it before your first visit. Most patients don't want to change horses in midstream just because of one fee.

Good luck!

Nae

stilldazed

I also agree with Rita and Nae. We've seen bills as high as $75. We have refused to pay and still held the employee accountable for providing medical certification. It is the employee's responsibility. What we have also seen in the past is that when the physician understands just how little information we need for FMLA purposes, the office was more than will to waive the fee.

davids

We are seeing this more and more often. One of the driving forces is that insurance companies have standard reimbursement rates. So, even if a physician increases his/her rates due to increased overhead, he/she will only receive the standard reimbursement rate from the insurance company. Charging to complete paperwork is a way for the physician to recoup some of the increased overhead outside of the insurance reimbursement.

As for who should pay for it, you will want to check your State law. In my state, statute mandates that the employer pay the cost of medical services that they (the employer) require. Arguably, if we are requiring the documentation, we need to pay the cost.