C. Physicians' expense for allergy treatment

Allergists commonly bill separately for the intial diagnostic workup and for the treatment. When it is necessary for the physician to provide treatment over an extended period, the allergist may bill in a lump sum for all of the treatments. It is a common practice for the entire physician's charge to be divided over the period of the treatment and billed periodically; e.g., monthly or quarterly.

Expenses for allergists' services are considered incurred when the services are actually rendered. When an allergist bills periodically for a course of treatment; the carrier may in the absence of contrary information assume that the physician's periodic bill relates to services rendered prior to the billing date.

When treatment is discontinued for any reason, no payment may be made towards that portion of the fee or charge which relates to any services which were not rendered. Similarly, no payment can be made for any of the services covered by an inclusive lump-sum charge which were performed in a month before the patient's coverage had begun or after the patient's coverage had terminated.