It pays to watch the medical and dental professionals.
I discovered that the office of one of the above professions was
assigning an incorrect professional procedure code to treatment that I was receiving.
(The code they assigned basically indicated a nebulous non-specific procedure, instead
of the specific procedure actually performed.)
This resulted in NO payment of benefits from the insurance company, and me footing the entire
cost of services rendered, to the tune of about double what I should have paid had
they coded the procedures correctly.
I compiled evidence from the web as to what the CORRECT procedure codes (recognized by my insurance) should have been, and the amount that I should have been responsible for as a copay.
The office manager, who assigned the incorrect codes, just brushed off my documentation,
indicating that he knew better. Basically he just blew me off, and told me I was fighting a losing battle pursuing
it any further.
He doesn't know me very well...............
One call to the head office proved my assertions to be correct, and I was (eventually, after many phone calls)
given a check refunding the difference.I had to have somebody climb the internal ladder to the top to get things done,tho.
Now, the question is: Do I blow the whistle on them?
I am sure that, having done it to me, they did likewise to other patients, probably in significant numbers.
At least out of the office I visited, and maybe other offices in the conglomerate (there are MANY!)
What should U do ??
Where do I go from here??