When i was younger and less confident I would just pay my bills when they come in. And they were not cheap but I figured, it was cheaper than if I didn’t have insurance right? About a year ago I had an exam where it was advised for me to have a Pap smear which then lead to an advisement for me to have a Colposcopy. The Pap smear I didn’t have to pay since it was coded as preventative (and my insurance covers preventative screening 100%) but the colposcopy ended up costing me $740.00. I dispute it with my insurance but that was rejected. I didn’t realize it’s because the medical provider had incorrectly coded it.
Fast forward to a couple of weeks ago, I visited the PA to inquire about my headaches (and she noted that it’s ongoing from my last few visits) so she suggested to either do a MRI or visit a neurologist. I had no idea which and when I tried to pin her down to advise one for me, she didn’t either so I finally decided to visit a neurologist first prior to doing an MRI.
I visited the neurologist and I got a bill for both visits. PA charged me $540.00 for “moderate to complex” office visit and the neurologist charged me $575 and after insurance I’m just under $200. I didn’t understand this discrepancy and why preinsurance, a run of the mill visit to a PA cost as much almost as a neurologist.
It took numerous msgs through their app portal before a Yelp review prompted the manager to reach out to me. Younger me would have accepted the manager’s attempt to justify the bill because she first stated that the contract she has with my insurance charges that much for moderate to complex so I asked what does that mean...she goes to tell me that she can’t say since that’s between the PA and me. Yet somehow when I mentioned that I’ve spoken to the PA previously about my headaches and can’t understand why this one would cost more she can somehow tell me that the other time I talked with the PA was during a physical exam so because physical exams are preventative that that complete office visit was covered. Wtf? And then I asked about the colposcopy and she mentioned that the Pap smear was preventative so therefore it was covered but the colposcopy was a procedure. I then walked through the logic of how I only had the Pap smear because it was a concern, and then based on the results did a colposcopy which to me was another test to further see if there was a concern...isn’t that preventative? So that it’s better to catch the cancer earlier then later?
In the end this office isn’t an office I can trust. I have a preexisting condition. I’ve lived in a hospital for six months where it was one week in, two weeks out, one week in, repeat. Because of that I’d like to think myself pretty well versed when it comes to insurance plans, what’s covered and what isn’t.
And I just realized that a lot of what people are going though (medical debt) could stem from incorrect coding. The same manager tried to tell me it’s highly unethical but in the same phone conversation was going to resubmit the colposcopy as a preventative screening and also knock off 50% of my recent office visit.
I hope this helps someone.
Submitted November 22, 2020 at 01:06AM by Greenappleflavor https://ift.tt/36Sn3Fu
