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Billing Codes and billing

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Phil Border Find out more about Phil Border
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  • #1

    Billing Codes and billing

    Recently we were billed what I think was an excessive amount - 'Other Imaging services General Classification' (that's all the bill said, though the about was a specific 737.00) , as well as for 'Cardiology General Classication (*over 3,200) and an EKG/ECG (412). I realize insurers 'negotiate' different rates, but how do you compare to ascertain you're not being taken advantage of? This helath care sysrtem is notirous for billing 'erros' that frequnely seem to be in their favor. HCM is streesful enouygh without having to actually deal with health care billing and insurers.

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  • #2
    Hi Phil,
    Welcome to the board. If you use Facebook, I'd encourage you to join the Facebook HCMA group - it has much higher volume than this board does.

    I don't have any comment on your question, except that (as I'm sure you know) there's an enormous difference between the amount billed and the "usual and customary" amount that an insurer will pay. I'm not sure I'd be concerned about what's billed (assuming that the services billed for were really performed); what matters is the amount you're on the hook for after the insurer pays.

    $412 for an ECG doesn't sound unusual to me; was the other imaging an echo? If so, that amount doesn't seem unusual either. The "Cardiology General," well -- that's so vague I have no thoughts at all!

    Gordon
    Myectomy on Feb. 5, 2007.

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