Topic: Get your Approval Codes?
I went for a Pet scan back on Feb 21. First it was denied, after a few calls, it was then approved, they had it all figured out how much I had to pay up front, which included my 2009 deductible of 500.00.
Fast forward, I had another scan in April, this time a ct scan. I get the insurance info as to how much they are paying on the Radiologist Fee, and get this, they are paying nothing, as it shows, I have not paid my deductible for 2009.
Just got off the phone with BCBS, they denied payment for the PET scan, as they did not submit the correct code, and had requested my medical records from the referring Dr as to why I needed the scan. Well, What about the prior authorization? It was approved? Oh, I am so frustrated!! She was telling me on the phone, that I need to contact the Dr. and have him send this information, then after digging deeper, found they already had it on file, and had not processed any of it.
So, now, depending, on whether the records they have requested, contains the correct code or not, I am now on the hook for the full amount of this other bill, and, the PET scan company, well, they apparently will owe us a refund, for that 500.00, IF, the dang insurance pays them.
This Country has got to do SOMETHING, with the way Health Care is being handled.
My point of the rant, I guess, talk to the insurance company yourselves when getting prior approval, and get any codes you can so when the Medical coders and billing companies file, they get timely payment. Not that I have a clue as to how any of this works. I figure we pay for the insurance, why should we have to track billing codes???