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re: What in the hell is wrong with medical billing?

Posted on 12/26/23 at 8:25 pm to
Posted by LeGrosChat
Bangladesh
Member since Feb 2016
414 posts
Posted on 12/26/23 at 8:25 pm to
quote:

The issue isn’t with the doctors office or the billers, it’s your insurance carrier.


The issue could just as easily be due to the doctor's billing.
Posted by BigBinBR
Baton Rouge
Member since Mar 2023
4593 posts
Posted on 12/26/23 at 8:39 pm to
quote:

The issue could just as easily be due to the doctor's billing.


Correct. A very large number of bill issues/insurance not paying is because the doctor’s off medical coding and billing is using the wrong codes for procedures.

Sometimes it’s a simple as the doctor’s office using ICD-9 instead of ICD-10. When the insurance company sends it back because ICD-9 doesn’t give enough info, the doctor’s office handles it as a denial and sends the bill to the patient.

Posted by AwgustaDawg
CSRA
Member since Jan 2023
7580 posts
Posted on 12/27/23 at 6:28 am to
quote:

The issue could just as easily be due to the doctor's billing.


It is 10-20 times a year with us and it does not matter which provider or how often you change they all make these "mistakes" and they do so in every market we have lived in. They make these "mistakes" multiple times a month with my Dad who is 84 and spends most his time at doctors offices. In 10 years of reconciling 10-5 EOBs a year for us and my Dad not once was it not a "mistake" on the part of the providers...and before someone chimes in and claims it was a small number of providers it is not, it is every last one of them spread out across the United States. In our experience. Maybe we are just unlucky and only go to providers who systmatically send fraudelent billing statements through the US mail...but everyone I know who has ever discussed it with me has had the same experience.
Posted by Saskwatch
Member since Feb 2016
16674 posts
Posted on 12/27/23 at 12:08 pm to
Medical billing practices are fukn criminal.

Medical/Healthcare/Pharma is preying on society.
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