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Learned a hard lesson
#21
(10-13-2015, 01:38 PM)justMongo Wrote:
(10-13-2015, 11:39 AM)Homerec130 Wrote: ...just changed over to a new coding system on Oct 1st. I went to get some bloodwork done and they refused it saying I had the old diagnosis codes on the form (even though they were correct when it was printed).

I just love paperwork.

Oct 1st, Medicare switched to ICD-10 codes. Which means many bills will be coded incorrectly for months.

Oh great.....just what I don't need. Medicare seems to be a real challenge anyway you look at it.

I have to pick up another form at the GPs office tomorrow and maybe this one will help Medicare get it right.

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#22
I've had a few bills denied by Medicare lately. Always the same answer from Medicare, denied due to a billing code error.

The thing is, the doctor, lab, hospital or whoever made the error is not allowed to charge you.
They must correct the error and resubmit. So don't pay that Ambulance bill if you think that it might be due to a coding error.
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#23
(10-13-2015, 04:31 PM)GrammaBear Wrote: I have to pick up another form at the GPs office tomorrow and maybe this one will help Medicare get it right.

I can't imagine what kind of form the GP could give you that would settle this matter. He needs to be giving information to Medicare and the ambulance company rather than directly to you. It's not your responsibility to deal with Medicare directly, it's the responsibility of the providers.

Dude
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#24
(10-13-2015, 05:47 PM)surferdude2 Wrote:
(10-13-2015, 04:31 PM)GrammaBear Wrote: I have to pick up another form at the GPs office tomorrow and maybe this one will help Medicare get it right.

I can't imagine what kind of form the GP could give you that would settle this matter. He needs to be giving information to Medicare and the ambulance company rather than directly to you. It's not your responsibility to deal with Medicare directly, it's the responsibility of the providers.

Dude

The form I will pick up is the one the ER doctor had to fill out that said it was "medically necessary" to call the ambulance. I realize it is the provider's responsibility but the bill from the ambulance service wasn't addressed to the provider and it won't be her credit rating that suffers, it will be mine.

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#25
(10-13-2015, 01:38 PM)justMongo Wrote:
(10-13-2015, 11:39 AM)Homerec130 Wrote: ...just changed over to a new coding system on Oct 1st. I went to get some bloodwork done and they refused it saying I had the old diagnosis codes on the form (even though they were correct when it was printed).

I just love paperwork.

Oct 1st, Medicare switched to ICD-10 codes. Which means many bills will be coded incorrectly for months.

Actually, it is industry wide and not just Medicare. I am on TriCare (bastard brother/sister of Medicare) and their codes have changed. One good thing about my insurance, if a doc takes Medicare, by law they have to accept TriCare standard. BTW, still haven't heard back from my doctor's office in the correct codes. That will be tomorrow's phone call.

Homer
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#26
(10-13-2015, 07:55 PM)GrammaBear Wrote: I realize it is the provider's responsibility but the bill from the ambulance service wasn't addressed to the provider and it won't be her credit rating that suffers, it will be mine.

GrammaBear,
The provider of the service is the ambulance service. They are billing you. Have you spoken to them directly? I would think that they would submit your info. (incl. drs. note if needed) to Medicare so they can get paid by Medicare.
Are they listed as the provider of service on the Medicare Explanation of Benefits on which the service was denied?

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#27
(10-15-2015, 02:44 PM)regbeach Wrote:
(10-13-2015, 07:55 PM)GrammaBear Wrote: I realize it is the provider's responsibility but the bill from the ambulance service wasn't addressed to the provider and it won't be her credit rating that suffers, it will be mine.

GrammaBear,
The provider of the service is the ambulance service. They are billing you. Have you spoken to them directly? I would think that they would submit your info. (incl. drs. note if needed) to Medicare so they can get paid by Medicare.
Are they listed as the provider of service on the Medicare Explanation of Benefits on which the service was denied?

Sigh........I have not spoken with the ambulance service directly. Just today I got a copy of the order signed by my doctor to "admit" me to the hospital. The facility where I saw the ER doctor hasn't got any 'inpatient beds', so the ambulance service was called to transport me to a nearby hospital that would accept me as an inpatient. I also printed a copy of the claim that was denied by Medicare and the ambulance service is listed as the 'provider'. Sometimes it is most difficult for me to talk on the phone, depending on the voice of the person to whom I'm speaking, because I am seriously hearing impaired. Sad

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#28
GrammaBear,
Hopefully, you or your husband will be able to hear the person on the phone at the ambulance service so you can resolve it quickly. Or perhaps you could get their fax number and send them the details of your request and supporting documents. Then, you could write it out and not have to worry about an extended phone conversation.
Good luck.


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