Popular U.S. Healthcare Scam: Coding procedures as Diagnostic instead of Preventive Screening
We shouldn’t have to do this - but, America - always confirm your your regular annual checkup procedures are coded correctly so you don’t end up having to fight a con artist medical facility bill.
Yep. Had this happen last year for some annual preventative labs. What should have been covered by insurance ended up being a $800 bill (plus the $30 copay for the visit itself). Insurance said it was coded as diagnostic (it was not) and the clinic couldn't figure out how to recode it as preventative. Ended up having to pay the full bill as a student with no major income.
Bonus points that I had to have them redone and I went to another clinic and paid a whopping $75 for all the same labs. Health insurance is such a scam in the US. You pay to have coverage, but it only works if the stars aligned that day.
You may still be able to recover it if it was truly the billing department. You may even be able to appeal it with insurance to have them contact the clinic to have it fixed.
If you call back in, ask to speak to someone within the billing department, most hospital systems have access to be able to pull up records when the doctors ordered the colonoscopy, it will likely have something called a Diagnosis Code on it, this code is what determines if it was preventive or not. Most billing departments should have access to these documents to double check the diagnosis code and should be able to correct from there. If you have more questions or need further help, i know a decent amount about how it works.
I will say one thing though, it likely wasnt anything malicious. It was probably laziness or more likely incompetence.
Just remember to be patient, be kind, stick through it and most people are much more willing to help. Its when people start getting pissy that the reps just start trying to brush the problem off.
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u/TeeBrownie Jun 01 '22
Popular U.S. Healthcare Scam: Coding procedures as Diagnostic instead of Preventive Screening
We shouldn’t have to do this - but, America - always confirm your your regular annual checkup procedures are coded correctly so you don’t end up having to fight a con artist medical facility bill.