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

Posted on 12/26/23 at 8:39 pm to
Posted by BigBinBR
Baton Rouge
Member since Mar 2023
4590 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
7579 posts
Posted on 12/27/23 at 6:34 am to
quote:

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.



Some providers simply use a collection agency from the git go to bill for their "mistakes". We have had this happen a couple of times. Get a bill from a collection agency. Call them to find out who the provider was...they usually pretend that they do not know but when they get the feeling that you are willing to pay they will divulge who the provider was, if there ever was one, we have also had that happen. When we contacted the provider they said they used the collection agency as their billing company and all of their bills came from the collection agency.
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