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    ahtnamas33's Avatar
    ahtnamas33 Posts: 4, Reputation: 1
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    #1

    May 18, 2011, 01:22 PM
    Dispute billing code
    My son was born in February and we were asked by the pediatrician in the hospital to have him return to the office in 3 days for a routine weight check. At that visit, we were then asked to have him return at 1 week and 2 weeks (of his age) for another routine weight check and PKU. For all of these visits we paid a 20 dollar co-pay each based on our insurance. I then discovered that well child visits by our insurance are covered at 100% and we should not have had a co-pay. After contacting the billing office today to determine why we had been charged, I was told that because the visits did not fall under the American Academy of Pediatrics recommeded well child visit of 2months, 4months etc... they were billed to the insurance company as something else. I feel really cheated by the dishonesty of this! We had been asked to return under the guise that these visits were part of routine well-child care and then suckered out of 60 dollars! I could have weighed my newborn at home as a very capable and employed pediatrics RN! Any suggestions?
    JudyKayTee's Avatar
    JudyKayTee Posts: 46,503, Reputation: 4600
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    #2

    May 18, 2011, 01:44 PM

    In light of this thread - https://www.askmehelpdesk.com/credit...ml#post2803598 - I am confused about what the situation is/was.

    I certainly would protest the bill if the vists were not medically necessary and you could have done the weighing and testing at home, yourself.

    If the billing codes were incorrect I would get that straightened out.

    I think these threads should be combined.
    ahtnamas33's Avatar
    ahtnamas33 Posts: 4, Reputation: 1
    New Member
     
    #3

    May 20, 2011, 02:15 PM
    I considered combining the threads, but they are for two different pediatricians offices for two different children in two different states. I figured each scenario was complicated enough to explain, and I didn't want to make anything more confusing than what it is! You seem to have some insight into this medical billing/health insurance world, it's great you can offer your exertise :)
    JudyKayTee's Avatar
    JudyKayTee Posts: 46,503, Reputation: 4600
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    #4

    May 20, 2011, 02:18 PM

    This has happened to you TWICE! Oh my gosh!

    I would protest the bill with the Pediatrician IN WRITING. Maybe he/she will change things, maybe not, but at least you'll be proactive.

    I had a somewhat similar situation - had surgery, Doctor wanted to see me once a week for 3 weeks for no apparent purpose other than to ask me how I was feeling. When I got the bill my health insurance paid for the surgery, minus a deductible, but NOT for the follow up visits. First, who operates and the cost doesn't cover follow ups and, second, why was I there once a week? I wrote a very polite letter - and the Doctor dropped the office visit charges. I'd give it a try.

    You seem to have some sort of "Pediatrician curse" following you around. I'd be afraid to walk into an office.

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