The doctor has to code the service provided, not for the service the patient has the best coverage. Labs can be coded as being done because of an illness which is known, or being done as screening tests. Insurance rules are very specific to your policy. Some carriers don't care why the test was done, some do. If you have a known illness then the doctor certainly didn't order tests without at least doing a history and hopefully vital signs and some element of a physical exam. As you say you were read the office note you should be able to evaluate what elements of an office visit were provided. If you were tested because of a diagnosis and to ascertain whether your therapy or disease were under control, that is not a routine lab (screening) it is a diagnostic lab. I have no idea what thyroid lab test would possible get you to $1000. That is where you may have to chat with the doctor. Did your medical situation require all the tests that were ordered or was every thryoid test known to man requested? Did the doctor do the labs in office or send you out to an independant ? In the first case the doctor makes the lab test profit which incentivises unnecessary testing. If you were sent out the doctor made no money on the tests. There are no kickbacks except maybe a Xmas fruit basket. The doctor cannot change the coding if it is already correct to try to get you better insurance coverage. That would be insurance fraud.
|