Guest guest Posted October 11, 2006 Report Share Posted October 11, 2006 Soma- it doesn't go by insurance company but by the contract the the employer or patient has selected and paid for. For example, in my area, Blue Cross and Blue Shield have some plans that pay for an annual preventative exam, and others that don't. You either have to ask the patient, do a precert check (pretty fast on some insurances web sites) or just submit it and change the visit charges when you get the eob denial back, if you've uncovered a few problems, or just bill the patient as a non-covered service. Where's your practice in NYC? Lynn > >Reply-To: >To: >Subject: Re: coding question >Date: Tue, 10 Oct 2006 17:08:15 -0000 > >Hi, I was introduced to this site by Moitri Savard. I just started my >own IM practice in NYC. It's been two months and overwhelming! >Can anyone tell me which insurance companies are more likely to >reimburse for the " preventative " visits? It seems like a random thing >and I've had to re-bill the ones that don't reimburse as an " office >visit " . > >Thanks! > >Soma > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 12, 2006 Report Share Posted October 12, 2006 Thanks Lynn! My practice is in Manhattan, Greenwich Village area. Right now I've just been basing it on what is stated on the EOBs, but based on your advice, I will need to research all the different plans and see what they will and won't cover. Soma Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 12, 2006 Report Share Posted October 12, 2006 RE Checking pt's well care. I'd try this -- 1) Most pts who are coming for a " checkup " really have a specific concern. VERY FEW initial visits are purely well care. 2) Even IF that plan " usually covers " well care, do NOT count on it! Thankfully, many plans in my area (western PA) have on-line access to check benefits. We usually do NOT do this at time of visit, but print out the benefits page before the next visit. I make a note in the chart of the date I check the well care benefit. 3) I also have a " well care dx " in my problem list, and mark the date " updated well care Oct 11, 2006 " so I don't try to do another one early, OR, remember to do another well care 1 year + 1 day after the next. Do check each pt, DO NOT ASSUME they have the benefit. Worth it! Dr Matt Levin FP, solo since Dec 2004 Residency completed 1988 SOAPware since 1997, but not paperless RE: Re: coding question > Thanks Lynn! > My practice is in Manhattan, Greenwich Village area. > Right now I've just been basing it on what is stated > on the EOBs, but based on your advice, I will need to > research all the different plans and see what they > will and won't cover. > > Soma > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 12, 2006 Report Share Posted October 12, 2006 About Insurance companies and their reimbursment policies: It appears to me to be variable depending on the plan and on the geographic location. It has gotten so that I call the company and ask them about the patient's coverage when they first establish care. That way I don't have to waste time rebilling. Joanne, from Drain, Oregon somamandal2000 wrote: Hi, I was introduced to this site by Moitri Savard. I just started my own IM practice in NYC. It's been two months and overwhelming!Can anyone tell me which insurance companies are more likely to reimburse for the "preventative" visits? It seems like a random thing and I've had to re-bill the ones that don't reimburse as an "office visit".Thanks!Soma Get your own web address for just $1.99/1st yr. We'll help. Yahoo! Small Business. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 12, 2006 Report Share Posted October 12, 2006 About Insurance companies and their reimbursment policies: It appears to me to be variable depending on the plan and on the geographic location. It has gotten so that I call the company and ask them about the patient's coverage when they first establish care. That way I don't have to waste time rebilling. Joanne, from Drain, Oregon somamandal2000 wrote: Hi, I was introduced to this site by Moitri Savard. I just started my own IM practice in NYC. It's been two months and overwhelming!Can anyone tell me which insurance companies are more likely to reimburse for the "preventative" visits? It seems like a random thing and I've had to re-bill the ones that don't reimburse as an "office visit".Thanks!Soma Get your own web address for just $1.99/1st yr. We'll help. Yahoo! Small Business. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 13, 2006 Report Share Posted October 13, 2006 This is a trivial question to address to the national audience but still it might be the easiest most efficient way to get an answer. We've gotten burned on ICD9 724.2 for Low Back Pain. It used to fly. Did we miss something? Admittedly we don't have the latest book yet. Thanks. From: [mailto: ] On Behalf Of joanne hollandSent: Thursday, October 12, 2006 2:06 PMTo: Subject: Re: Re: coding question About Insurance companies and their reimbursment policies: It appears to me to be variable depending on the plan and on the geographic location. It has gotten so that I call the company and ask them about the patient's coverage when they first establish care. That way I don't have to waste time rebilling. Joanne, from Drain, Oregon somamandal2000 wrote: Hi, I was introduced to this site by Moitri Savard. I just started my own IM practice in NYC. It's been two months and overwhelming!Can anyone tell me which insurance companies are more likely to reimburse for the "preventative" visits? It seems like a random thing and I've had to re-bill the ones that don't reimburse as an "office visit".Thanks!Soma Get your own web address for just $1.99/1st yr. We'll help. Yahoo! Small Business. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 13, 2006 Report Share Posted October 13, 2006 What do you mean “got burned”? They throw out the whole claim? I use that ICD-9 all the time & have no problems with it. If you are trying to get an MRI approved, doing manipulation, etc then that 724.2 may be too generic for that. But, it should certainly be OK just for getting an E/M claim covered. Re: Re: coding question About Insurance companies and their reimbursment policies: It appears to me to be variable depending on the plan and on the geographic location. It has gotten so that I call the company and ask them about the patient's coverage when they first establish care. That way I don't have to waste time rebilling. Joanne, from Drain, Oregon somamandal2000 <somamandal2000> wrote: Hi, I was introduced to this site by Moitri Savard. I just started my own IM practice in NYC. It's been two months and overwhelming! Can anyone tell me which insurance companies are more likely to reimburse for the " preventative " visits? It seems like a random thing and I've had to re-bill the ones that don't reimburse as an " office visit " . Thanks! Soma Get your own web address for just $1.99/1st yr. We'll help. Yahoo! Small Business. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 13, 2006 Report Share Posted October 13, 2006 What do you mean “got burned”? They throw out the whole claim? I use that ICD-9 all the time & have no problems with it. If you are trying to get an MRI approved, doing manipulation, etc then that 724.2 may be too generic for that. But, it should certainly be OK just for getting an E/M claim covered. Re: Re: coding question About Insurance companies and their reimbursment policies: It appears to me to be variable depending on the plan and on the geographic location. It has gotten so that I call the company and ask them about the patient's coverage when they first establish care. That way I don't have to waste time rebilling. Joanne, from Drain, Oregon somamandal2000 <somamandal2000> wrote: Hi, I was introduced to this site by Moitri Savard. I just started my own IM practice in NYC. It's been two months and overwhelming! Can anyone tell me which insurance companies are more likely to reimburse for the " preventative " visits? It seems like a random thing and I've had to re-bill the ones that don't reimburse as an " office visit " . Thanks! Soma Get your own web address for just $1.99/1st yr. We'll help. Yahoo! Small Business. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 13, 2006 Report Share Posted October 13, 2006 In general, that code is frowned upon and seen as non-specific. Most insurers prefer a more detailed diagnosis code as to the source or type of back pain (muscle spasm, facet syndrome, pregnancy induced, etc.) Lumbago is old school....much like the term rheumatism. Brett L. Kinsler, DC Rochester, NY ....... Original Message ....... On Fri, 13 Oct 2006 10:05:42 -0400 Hilsbos wrote: >This is a trivial question to address to the national audience but still >it might be the easiest most efficient way to get an answer. > >We've gotten burned on ICD9 724.2 for Low Back Pain. It used to fly. >Did we miss something? Admittedly we don't have the latest book yet. > >Thanks. > > >________________________________ > >From: >[mailto: ] On Behalf Of joanne >holland >Sent: Thursday, October 12, 2006 2:06 PM >To: >Subject: Re: Re: coding question > > >About Insurance companies and their reimbursment policies: It appears >to me to be variable depending on the plan and on the geographic >location. It has gotten so that I call the company and ask them about >the patient's coverage when they first establish care. That way I don't >have to waste time rebilling. > > Joanne, from Drain, Oregon > >somamandal2000 wrote: > > Hi, I was introduced to this site by Moitri Savard. I just >started my > own IM practice in NYC. It's been two months and overwhelming! > Can anyone tell me which insurance companies are more likely to > reimburse for the " preventative " visits? It seems like a random >thing > and I've had to re-bill the ones that don't reimburse as an > " office > visit " . > > Thanks! > > Soma > > > > >________________________________ > >Get your own web address for just $1.99/1st yr ><http://us.rd.yahoo.com/evt=43290/*http://smallbusiness.yahoo.com/domain >s> . We'll help. Yahoo! Small Business ><http://us.rd.yahoo.com/evt=41244/*http://smallbusiness.yahoo.com/> . > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 13, 2006 Report Share Posted October 13, 2006 In general, that code is frowned upon and seen as non-specific. Most insurers prefer a more detailed diagnosis code as to the source or type of back pain (muscle spasm, facet syndrome, pregnancy induced, etc.) Lumbago is old school....much like the term rheumatism. Brett L. Kinsler, DC Rochester, NY ....... Original Message ....... On Fri, 13 Oct 2006 10:05:42 -0400 Hilsbos wrote: >This is a trivial question to address to the national audience but still >it might be the easiest most efficient way to get an answer. > >We've gotten burned on ICD9 724.2 for Low Back Pain. It used to fly. >Did we miss something? Admittedly we don't have the latest book yet. > >Thanks. > > >________________________________ > >From: >[mailto: ] On Behalf Of joanne >holland >Sent: Thursday, October 12, 2006 2:06 PM >To: >Subject: Re: Re: coding question > > >About Insurance companies and their reimbursment policies: It appears >to me to be variable depending on the plan and on the geographic >location. It has gotten so that I call the company and ask them about >the patient's coverage when they first establish care. That way I don't >have to waste time rebilling. > > Joanne, from Drain, Oregon > >somamandal2000 wrote: > > Hi, I was introduced to this site by Moitri Savard. I just >started my > own IM practice in NYC. It's been two months and overwhelming! > Can anyone tell me which insurance companies are more likely to > reimburse for the " preventative " visits? It seems like a random >thing > and I've had to re-bill the ones that don't reimburse as an > " office > visit " . > > Thanks! > > Soma > > > > >________________________________ > >Get your own web address for just $1.99/1st yr ><http://us.rd.yahoo.com/evt=43290/*http://smallbusiness.yahoo.com/domain >s> . We'll help. Yahoo! Small Business ><http://us.rd.yahoo.com/evt=41244/*http://smallbusiness.yahoo.com/> . > > Quote Link to comment Share on other sites More sharing options...
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