Hi All,
I am no fan of insurance companies (or medicare for that matter) but have seen a practice done that seems at best unethical and at worst illegal. When patients come in for cataract surgery evaluations or even simple glaucoma checks the doc fills out the billing form and submits it to the billing dept. If the insurance company will not cover the procedure/exam billing sends it back to the doctor to determine if another code is more appropriate (i.e. a code that insurance will cover)
Shouldn't the billing code be whatever was determined during the exam? It is done at many of the companies I have seen in my area and I can not imagine the insurance companies would appreciate it...changing the code to something similar so that it will be covered...
Does this happen often?
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