1formissy
Guru
As a seasoned coder and auditor, I reviewed my husbands documentation from the services he had rendered when he was hospitalized. (He is self pay).
I was SURPRISED that the documentation I reviewed was excessively documented, billed at high level E/M's and he was charged for Critical Care. I was with him the ENTIRE time and he was NOT critical care, and the services which were documented were NOT done.
Therefore, I sent an appeal to the billing office, and outlined why I (I am an authorized representative of my husband) disagree with the charges. I received a response back stating, "That is what was documented, and that is what is billed."
Since he does not have insurance, I really do not know what rights he has as a self pay? Should I request the assistance of our Ombudsman? Anyone have any thoughts, ideas?
I was SURPRISED that the documentation I reviewed was excessively documented, billed at high level E/M's and he was charged for Critical Care. I was with him the ENTIRE time and he was NOT critical care, and the services which were documented were NOT done.
Therefore, I sent an appeal to the billing office, and outlined why I (I am an authorized representative of my husband) disagree with the charges. I received a response back stating, "That is what was documented, and that is what is billed."
Since he does not have insurance, I really do not know what rights he has as a self pay? Should I request the assistance of our Ombudsman? Anyone have any thoughts, ideas?