 |
 |
 |
|
|
|||
|
|
||||
|
||||
PREGNANCY: Insurance billing/coding for miscarriage at 13 1/2 weeksFrom: Sara (anonymous@obgyn.net)Fri, 29 Feb 2008 10:14:51 -0600 (CST)
I am having a problem with my ob's office. I miscarried at 13 1/2 weeks. Baby measured at 13 weeks. I have an HMO plan. 1st visit is $15.00 copay. Everything else including the hospital is covered for the rest of the pregnancy. I had ob visits on 12/26 (5 1/2 weeks), 1/18 (8 1/2 weeks), 2/15 (12 1/2 weeks), and then I came in on 2/21 to discuss options as there was no heartbeat at my peri appt at 13 1/2 weeks. The last visit we scheduled my d&c for the next day. I went online to check my claims and my ob's office has billed for every visit that I had. I can understand a copay on the 21st as surgery was scheduled (that can technically be called a pre-op visit), but my other two visits should have been covered under maternity. Called my insurance company and they say that I was charged office visits not prenatal. They told me to call the billing office and have them recode as prenatal visits. Called the billing office and she says I was charged correctly because there is not a code for less than 4 visits. So you get charged each visit. Let me say this billing clerk is very difficult to work with. I have had problems getting her to get me a referral for the perinatologist and for an endo specialist. I had to get my insurance company involved both times to get it straightened out. ONLY after my insurance company got involved would she do the referral. She kept telling me I didn't need one and I did. The billing clerk told me that my first visit doesn't count as it was an amnoreah visit. I told her, I was pregnant and they did a pregnancy test. So I call my insurance company back and they said that was crap (literally), that she was not coding correctly. They say one pregnancy is $15 copay for me, whether 5 weeks or 40 weeks. So is this true? If I really do owe the money, I don't have a problem paying it. I do have a problem with being billed inappropriately. I tend to know what my insurance covers as I work as a contract specialist, so I read the fine lines. Is this proper billing for a miscarriage at 13 1/2 weeks. It's like adding insult to injury here. My insurance company says I don't have to pay the additional money and they will having a patient advocate call me. I think they are goingt to be having the advocate call my ob's office.
|
|
Return to ![[ Women's Health Forum ]](http://www.obgyn.net/images_women/wh-forum.gif)
Report TECHNICAL Problems ONLY to: webmaster@obgyn.net
Last Updated: Mon Nov 2 07:03:16 2009
Women's Insurance Checklist from Auto Insurance Quote
home | medical professionals | women | industry | forums | international