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Exactly. Dealing with the back and forth between the insurance company and the provider today, actually. What a hassle. Only over $150 for charging me for an an
by francisofascii 6y ago
Exactly. Dealing with the back and forth between the insurance company and the provider today, actually. What a hassle. Only over $150 for charging me for an annual preventative care visit which should be covered by insurance. Normally I would just pay to avoid the hassle, but this I will try to fight it.
- lotsofpulp 6y agoI've dealt with the same nonsense. Is this your first time with that specific doctor? The doctor has to use one of the annual wellness visit codes, so if it's your first time, the doctor will charge you a new patient charge code, which is higher reimbursement than a wellness visit code, so insurers will deny it. However, I was able to tell my doctor's office that I want the wellness visit charge code only, and they did that. I don't even see a reason for the new patient visit code to exist, since they are allotted the same time and subject matter. For example: https://content.highmarkprc.com/Files/EducationManuals/GeriatricResourceBinder/gerbinder-cpt-codes.pdf https://content.highmarkprc.com/Files/EducationManuals/Geria... If a doctor bills for code 99387, that might not covered under "annual wellness visit" or "annual physical" by the insurer, so you end up having to pay the whole amount if you haven't met your deductible. If the doctor bills code 99397, then it would be. But it shouldn't be this hard. The insurer should be forced to show the codes that qualify for the free annual wellness visit, and you should be able to inform the doctor's office that you want to purchase services for that code and that code only.