I have been a nurse for over 40 years, the last 15 in an office in Jacksonville, AND, I am a medical coder. This is the advice I give EVERYONE.. CALL YOUR INSURANCE COMPANY FIRST! The phone # is on the back of your card. They pay the bill, they know what your particular plan covers. If they say it’s covered & you get a bill, call them back, with bill in hand, & ask if you owe this. Usually you don’t & they will contact the biller. The cause of the problem is most commonly that they used the wrong ICD-10 code to bill with…resubmit with the correct code & like magic…they get paid. I did this for a living & recuperated thousands of $$ for the office I worked for (that they thought they had to write off.) Unfortunately the US government has made this so difficult & such a game, that even the people in a lot of medical offices don’t understand it because they can’t afford to hire the folks with degrees in Health Information Management, like the hospitals can, who know the game & coding in totality. Sad, but a fact of life. Good luck & remember, NEVER pay a medical bill, except your copay, without calling your insurance provider FIRST! (Even the beginning of the year deductible is tracked by your insurance & they can say when you have met it, since the offices don’t have that info.)
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