• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki CLaims not paid

Create Wiki
A

ambar1116

Guest
Messages
1
Best answers
0
The physician I work for is out of network with Coventry Health Plan, one night he was on call and he was called in to perform a surgery on a patient that was seen in the ER Department. The old coder billed 99223-25, 11012 and of course the claim denied, not even the hospital got paid. Was this the correct way of billing this claim? Please help I'm not a coder but the office manager but I believe these procedures were billed correctly. Please advise.
Thanks in advance! :)
 
Appeal the out of network as this was an emergency procedure, not an elective surgery. Call Coventry and raise a ruckus. Also have the insured (patient) call and complain as well...otherwise, the patient will have to foot the bill.
 
You must log in or register to reply here.
Top