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Another Medical Billing RANT!
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<blockquote data-quote="Muddyboots" data-source="post: 2813992" data-attributes="member: 63925"><p>Well my experience is from recent interactions with medical doctors, their billing depts and Medicare.</p><p></p><p>I had surgery came out with dislocated jaw. Doc says not covered, billing says not covered, Medicare says not covered. I had jaw fixed by non Medicare doc since none in area anyway. I decided to review Medicare code book and what do you know? My doc was wrong, his billing dept was wrong and Medicare was wrong. If dislocation not related to dental procedure, then it is covered. So all three had it wrong. This resulted in significant financial loss to me from their incompetence. But hey, what do I know, I only reviewed and provided legal interpretation to multibillion global company on complex environmental regulations worldwide.</p><p></p><p>Second instance post surgery Ice Machine therapy for shoulder. Doc says not covered, billing says not covered, Medicare says not covered. I decided to review Medicare code book once again and what do you know? My doc was wrong, his billing dept was wrong and Medicare was wrong. I provided Medicare their own code and they sent me full check for coverage. But hey, what do I know, I only reviewed and provided legal interpretation to multibillion global company on complex environmental regulations worldwide.</p><p></p><p>So my experience is if no legal citation is provided, then any opinion is just that, an opinion. I refuse to accept verbal opinions based upon what I experience. And I have helped others find their codes in the Medicare code book. So no data means nothing to me.</p></blockquote><p></p>
[QUOTE="Muddyboots, post: 2813992, member: 63925"] Well my experience is from recent interactions with medical doctors, their billing depts and Medicare. I had surgery came out with dislocated jaw. Doc says not covered, billing says not covered, Medicare says not covered. I had jaw fixed by non Medicare doc since none in area anyway. I decided to review Medicare code book and what do you know? My doc was wrong, his billing dept was wrong and Medicare was wrong. If dislocation not related to dental procedure, then it is covered. So all three had it wrong. This resulted in significant financial loss to me from their incompetence. But hey, what do I know, I only reviewed and provided legal interpretation to multibillion global company on complex environmental regulations worldwide. Second instance post surgery Ice Machine therapy for shoulder. Doc says not covered, billing says not covered, Medicare says not covered. I decided to review Medicare code book once again and what do you know? My doc was wrong, his billing dept was wrong and Medicare was wrong. I provided Medicare their own code and they sent me full check for coverage. But hey, what do I know, I only reviewed and provided legal interpretation to multibillion global company on complex environmental regulations worldwide. So my experience is if no legal citation is provided, then any opinion is just that, an opinion. I refuse to accept verbal opinions based upon what I experience. And I have helped others find their codes in the Medicare code book. So no data means nothing to me. [/QUOTE]
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Another Medical Billing RANT!
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