Prevent medical bill error proactively?

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jgdsss
Posts: 131
Joined: Mon May 16, 2016 11:31 pm
Location: Florida

Prevent medical bill error proactively?

Post by jgdsss »

Getting an outpatient procedure soon and I got an estimate from
Hospital. It lists several CPT Codes correlating to the surgery (there are probably four codes bc i guess that’s how it’s done…some codes equal $0 and then one equals $2,100). We met deductible for this year so we will be responsible for the roughly $2,100 (because of co-insurance). I’m not 100% why three codes = $0 and one code works out to $2,100.

Since this is an estimate made before the procedure, how do I know if this is correct? I assume after the procedure, if they need to do anything else, it would be coded as such. Do I check with insurance or with the hospital to ensure these codes are right? I know a very high percentage of medical bills are incorrect so trying from figure out how to prevent that (or how to determine these codes are indeed right).
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Eagle33
Posts: 2392
Joined: Wed Aug 30, 2017 3:20 pm

Re: Prevent medical bill error proactively?

Post by Eagle33 »

You could request another quote from the hospital to see if it matches the first one. Contacting the insurance company may at best confirm the codes are applicable for your upcoming procedure, but not guarantee these are the codes that will be used for the insurance claim after the procedure. And the actual codes the hospital will use will also depend on the actual specific services provided during your procedure. I'm not sure you can get accurate codes pre-procedure, considering my service provider has changed codes after submitted claim is rejected and resubmitted the claim with different codes.
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