Helping a Provider Market

We had an interesting thread on our forum this past week regarding a medical billing service that was asked by a new provider to help them find patients for their new practice. Sounds innocent enough but as Linda Walker pointed out, we need to look deeper as this is a very tricky scenario.

Anti kickback statutes can be violated by the medical billing service if they help the provider market their services. The law says that splitting fees from any referrals from a non-provider is strictly prohibited. For more information on these laws you can “google” federal anti-kickback laws or federal Stark regulations.

So what about sending reminders to a provider’s patients who have not been in for awhile. Is it alright for a billing service to offer this service? If the results of a billing service sending reminder notices to a patient is that the patients make appointments and come in then the billing service is then making money off the services provided by the doctor thus violating the anti-kickback laws.

I guess the next question is are these laws enforced when they seem so unfair? Unfortunately the answer is yes. It is very easy to find many examples of lawsuits involving such charges on the web. So it seems to me that it is just not worth taking the chance even though you would like to see your providers prosper. So how can you help?

My first question when I read the post was is it ok to just suggest marketing techniques to them that others have used. You are not actually helping them or participating with the marketing. It would be so easy to just say why don’t you try display ads, or press releases. Seems harmless, but if the suggestion you make ends up resulting in referrals, then technically you have broken the anti-kickback law. Personally I don’t want to take any chances.

I guess the only thing we as billing services can do to help a provider who is trying to drum up business is to refer them to a marketing firm. It might even be a good idea to find a local one that you like the work of. You don’t want to be partnered with them in any way, or else you will be benefiting. But you can get to know them and if you like how they operate, refer to them. It is important that you understand the anti-kickback law so you aren’t caught in something that can get you into trouble. Ignorance is not a defense.


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