Saturday, March 10, 2012



The best thing about life is,
it moves forward!

The past two weeks have been hectic
Year end taxes
Busy with appointments at the Salon and Personal
And dealing with people to correct incorrect billing...grrr
this last one just really hits a nerve with me and can be a full time job!

I guess because my past positions have required me to code accordingly for medical treatment,
over seeing the submission of correct billing with the diagnosis...
My tolerance has become less to none when I see the denial for payment...!

Understanding the billing and coding of any medical treatment has become very crucial with todays
health care and insurance companies. 
Let's face it, insurance companies will try to not pay a claim if they
 find the slightest infraction with the coding that is attached to the claim..!!!

My words of advice are:
  • Know what your being treated for and why..!
  •  Read your bill with diagnosis(usually at the bottom of bill) before leaving office..
  • Read all forms sent to you from your insurance company and what the reasoning may be for denial of payment if there is one
  • Look at adjustments of payment made from insurance company 
and what was paid to provider or facility
  • Know what your deductible is
  • Have you meet your deductible for the year
  • Does your deductible coincide with the calendar year of time of first treatment
If your in treatment and during your treatment your required to meet a new deductible for the new year, your treatment will then start back to day one of allotment time for that treatment. (in other words, say you started a treatment in November and your deductible had been met for 12 weeks of treatment, the new calendar year on January 1 comes around and  requires you to meet your deductible again for the new calendar year, but the insurance company claims after the initial 12 weeks of  treatment time has been exhausted into the new year your not approved by the insurance company to have another 12 weeks of treatment, NOT so if your required to meet a new deductible at the new calendar year. Your treatment would start over at day ONE..insurance companies will try to talk their way around it, but fight for what is owed to you..)
you will win!!
 And lastly, the most important...if your insurance company is participating with the provider or facility your having treatment with, make sure your not being billed for the difference of the amount not paid by the insurance company.  This is illegal...! 
And if your having to pay out of pocket for the treatment, ask if they give discounts for self pay. 
Most providers/facilities do, take advantage of it...!
And don't ever be afraid to questions,
Its your right and helps you to understand why...or if your being ripped off!!
I hope this bit of information is helpful should you ever need it...


The week ended with taxes being filed 
Spending time with friends and running into old neighbor hood friends from my youth
and just enjoying this awesome early Spring weather!!

Have a Fantastic Weekend My Friends...!!

K






2 comments:

  1. Great advice and I agree with you totally. I examine each and every bill I get. I'm not about to pay for something A I didn't get or B overcharged. Thanks for a great post!

    Donna

    ReplyDelete
    Replies
    1. Hey Donna...Thanks for stopping by and your comment! Awareness is so important for every day daily living. Have a great Saturday and the rest of the weekend..!
      K

      Delete

Thanks for the visit....! I encourage and look forward to your thoughts and comments. Many Blessings...K

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