I went to my in network OB/Gyn and got a preventative service at the beginning of the year. Before making the appointment I was assured it was 100% covered. Then I got a bill for almost $1000. I called and they said they had filed it wrong and refiled it. The bill didn’t go away and I was able to call again before it went to collections and it was escalated and they said whomever tried to fix it didn’t do it correctly and they would refile it… now again I got another payment notification from the doctors saying I owe them money and want to send me to collections. Before I call my insurance again, does anyone have any advice on how I can make sure they don’t mess it up again? Every time I called my insurance, Every person assured me my service was 100% covered so I shouldn’t be expected to pay this.
What’s the code that OB billed to your insurance? I’m assuming something happened during the visit that made it not qualify as preventative.
Without the billed procedure codes and the diagnosis codes assigned to each, it’s hard to help you figure this out. I work in insurance and am a Certified Professional Coder. I’m happy to help you figure this out—feel free to send me a DM if you don’t want to share your private information here.
I just spoke with my insurance again. The person I talked to said the provider coded the procedure as diagnostic instead of preventative. Earlier, other representatives told me it was an insurance coding issue and said they had “reprocessed” it. Today’s person mentioned they created a ticket but couldn’t explain what a ticket was. Do you know? I didn’t realize that providers handle the coding, as I’ve never used insurance before and trusted what the initial representatives told me. At least I understand what happened now.
How do you know it is the insurance companies fault? Preventative stuff is often misunderstood by most parties.
The insurance company admitted the mistake on their part both times I contacted them. First time they said that they coded it incorrectly and would re-code it. And then the next time I called they said whomever tried to recode it did so incorrectly and they would do it again. Both times they agreed what I got was covered.
I just received a bill from my OB visit for preventative care. The bill covered everything except for code 90000, which is for transporting the specimen to the lab.