[Theresa]

Here is something to do with health insurance claims that get denied.

You contact the provider’s billing and coding and see if they made a mistake when they did the coding for the insurance claim.

Usually they keyed in the wrong code.

[Deb]

So, is there anyone here that can help with coding? My insurance company says I can get a full set of blood work once a year if it’s coded as Annual Wellness which I believe is a letter is z code?

But for some reason when the lab sent the claim to the insurance company, Blue Cross Blue shield, they coded it as a maybe an ID 90, said because of how doc ordered it?

and Blue Cross Blue Shield says they won’t pay it because I haven’t met my deductible and so now the lab company wants $900 for a routine blood work panel.

Any ideas?

[Leah]

If you talk to the insurance company they will usually tell you what code they should have used to bill the procedure.

[Tina]

exactly I had a bill go to collections and fighting with them for over a year. finally it was straightened out and owe nothing.

bill collections still owe it

[June]

I believe that happened to me last spring. Contacted provider—twice— and was told I’d hear from them. I didn’t hear from them.

Frustrating

[Patti]

Did this when dental work was denied after service. Talked with the company and asked what it needed to say and then passed this on to the dentist office.

It was bizarre that they will basically tell you how it needs to be worded but they did.

[Sharon]

Several years ago, a billing assistant in the practice I use, told me that whenever there was a surprise about a charge the first thing to do is question the billing.

She said the system is so complex that it’s really easy for staff to make mistakes.

[Melissa]

I had this happen with an emergencyroom visit out of my area. My child was in anaphylaxis reaction. Her airway was closing.

It was miscoded as a nonemeegency. I callwd the insurance and we talked about the entire experience and she changed the coding.

We also go over inpatient billing so nnone is charge for things that didn’t happen.

An example is, I brought my own RX medications.

[Annette]

This is good information. I received a statement for x-rays, called to ask why and it was a wrong billing code.

I didn’t have to pay the bill. It is always worth asking.

[Judy]

Don’t forget if you are scheduled for an Annual exam, and you bring up issues outside the realm of an Annual exam it is billed as such.

[Duncan]

If we had a decent medical system it would not be neccesary , heres hoping 8 years is a charm.

[Diane]

Darn coding it messes stuff up if input wrong. My friend does medical billing and comes across this alot

[Author]

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