tag:blogger.com,1999:blog-18943510.post9196853087645737188..comments2023-08-21T02:57:37.362-05:00Comments on Dr. Wes: Our New InquisitorsDrWeshttp://www.blogger.com/profile/17438019699222125477noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-18943510.post-23589179184476561632013-04-17T20:45:47.108-05:002013-04-17T20:45:47.108-05:00Two things to think about
(from a medical coder/bi...Two things to think about<br />(from a medical coder/biller)<br />1) Let the patient know they are on the hook for the medical care. Once they know how expensive it is, it becomes a major incentive to live a healthy lifestyle. (as one of my MDs told a pt. "you can buy a lifetime gym membership for half the price of one CABG.)<br />2) Point out how cheap their current insurance company is, CodeMonkeynoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-78073713693786832492013-03-24T09:16:18.254-05:002013-03-24T09:16:18.254-05:00When a family member ended up in ER recently, it w...When a family member ended up in ER recently, it was a brand new world for all of us. When the bills rolled in, they had all been submitted to the secondary first instead of the primary. Hours of phone calls later, that was " fixed" and all bills were resubmitted. Then came the big surprise. Some MD from the insurance company deemed the patient's hospitalization for her brand new, Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-27563227860929700512013-03-20T18:29:08.633-05:002013-03-20T18:29:08.633-05:00Wes,
What a travesty that you should have to plea...Wes,<br /><br />What a travesty that you should have to plead and beg to be justly compensated for work that you performed and was pre-approved (fine print stipulations aside, as noted in your comment to Dan).<br /><br />This is just one example of physicians being steamrolled by large, politically connected entities grabbing for a bigger piece of the healthcare dollar "pie". In part, aW.O.R.M.noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-21302874251983092222013-03-20T17:49:02.814-05:002013-03-20T17:49:02.814-05:00Dan -
Check your policy. Almost every insurer o...Dan - <br /><br />Check your policy. Almost every insurer out there requires pre-authorization of services for elective procedures and has a clause (like <a href="http://www.bcbstx.com/trs/preauthorization.htm" rel="nofollow">this one</a>, for instance) that says something like: "Preauthorization ensures that care and services will not be denied on the basis of medical necessity. <b>DrWeshttps://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-50632586467824367682013-03-20T14:43:39.415-05:002013-03-20T14:43:39.415-05:00I'm not a doctor, but "a denial for payme...I'm not a doctor, but "a denial for payment on a portion of a patient's pre-authorized procedure after the fact" sounds like they authorized the procedure, then afterwards decided not to pay for it. Surely they can't do that, can they? How could they possibly justify that? Isn't it, say, theft of services?Danhttps://www.blogger.com/profile/11969254346376018459noreply@blogger.com