View Full Version : Getting Insurances to pay claims.
larmary
Sep 6, 2008, 10:15 AM
I work at an eye doctor's office. I am having trouble getting insurances to pay for medical procedures that should be covered. When I call I sometimes get a foreign country other times I get someone that tells me to call a CPT code person/organization because they can not tell me what code to use to get it paid. The CPT tell me I am using the right code. So it is an impasse. Help!
Fr_Chuck
Sep 6, 2008, 10:20 AM
Your doctors office should have someone who is trained and knows the proper codes if not you should hire a outside biling company that does this professionally.
Also coverage for that person should be verified prior to treatment.
If the insurance company is not paying on valid codes you do have the right to sue them or merely go back to the patient for payment and let the patient deal with the insurance company.
larmary
Sep 6, 2008, 10:58 AM
We do have a Insurance person - very knowledgeable and trained - They were stumped and I was trying my hand at getting an answer.
ChihuahuaMomma
Sep 6, 2008, 07:31 PM
The doctor should know the appropriate code to bill. What procedure are you curious about? What insurance is it? Keep in mind that insurance companies will search out reasons to deny your claim, so always make sure that every tiny piece of information is correct.