Guest guest Posted March 30, 2001 Report Share Posted March 30, 2001 Get back with the doctor's office and have them change the code. You should not have to pay unless you have a deductable on your insurance. MJ GayleneCo@... wrote: > > Hi Everyone, > > I have a couple of questions. I just had my one year lab work done and it was > denied by my insurance company. The total was almost $700. When I called Blue > Cross they said that the diagnostic code said " obesity " and that is not a > covered expense. When I said they had covered the insurance and I wasn't > obese any longer they said to have the Doctor's office re-submit the bill > with a different diagnostic code. Then I called Valley Surgical. They said > it's not covered. I told them the lab would be contacting them for a > different code and explained that my B-12 level was low and was basically > told that the nurse would have to handle it. So far, no call back from the > nurse. (Personally I don't think it's the nurse's responsibility, but what do > I know.) > > OK.......now the questions. Does everyone pay for their lab work? Is it > always $700? If not, does anyone know what I can do to make the insurance > company pay? > > Thank You, > Gaylene > Dr. Boone > 3/16/00 > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2001 Report Share Posted March 30, 2001 Gaylene, Have them use the ICD-9 code for malnutrition. If they want me to tell them what it is, I can get back with you on Monday with the right #. I work for my surgeon and we submit this diagnosis code with success all the time!!! Michele Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2001 Report Share Posted March 30, 2001 I agree with Amber. I am 7 years post op and have not had to pay for labs. Mine is always coded for post surgery follow up. I only pay my co pay with Blue Cross and that is for the surgeon's office visit at my follow up appts. Rita lab work payments >> >> >> Hi Everyone, >> >> I have a couple of questions. I just had my one year lab work >> done and it was >> denied by my insurance company. The total was almost $700. When I >> called Blue >> Cross they said that the diagnostic code said " obesity " and that is not a >> covered expense. When I said they had covered the insurance and I wasn't >> obese any longer they said to have the Doctor's office re-submit the bill >> with a different diagnostic code. Then I called Valley Surgical. >> They said >> it's not covered. I told them the lab would be contacting them for a >> different code and explained that my B-12 level was low and was basically >> told that the nurse would have to handle it. So far, no call back >> from the >> nurse. (Personally I don't think it's the nurse's responsibility, >> but what do >> I know.) >> >> OK.......now the questions. Does everyone pay for their lab work? Is it >> always $700? If not, does anyone know what I can do to make the insurance >> company pay? >> >> Thank You, >> Gaylene >> Dr. Boone >> 3/16/00 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2001 Report Share Posted March 30, 2001 You need another code, pure and simple, obesity is no longer the case. If you had an rny they could use the code for short bowel syndrome, and/or one for malabsorption. I have never paid for labs and I am 17 mos post-op. Amber > lab work payments > > > Hi Everyone, > > I have a couple of questions. I just had my one year lab work > done and it was > denied by my insurance company. The total was almost $700. When I > called Blue > Cross they said that the diagnostic code said " obesity " and that is not a > covered expense. When I said they had covered the insurance and I wasn't > obese any longer they said to have the Doctor's office re-submit the bill > with a different diagnostic code. Then I called Valley Surgical. > They said > it's not covered. I told them the lab would be contacting them for a > different code and explained that my B-12 level was low and was basically > told that the nurse would have to handle it. So far, no call back > from the > nurse. (Personally I don't think it's the nurse's responsibility, > but what do > I know.) > > OK.......now the questions. Does everyone pay for their lab work? Is it > always $700? If not, does anyone know what I can do to make the insurance > company pay? > > Thank You, > Gaylene > Dr. Boone > 3/16/00 > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2001 Report Share Posted March 30, 2001 In a message dated 03/30/2001 5:01:55 AM Pacific Standard Time, GayleneCo@... writes: > OK.......now the questions. Does everyone pay for their lab work? Is it > always $700? If not, does anyone know what I can do to make the insurance > company pay? > > Thank You, > Gaylene > Dr. Boone > 3/16/00 Because you had a surgical procedure that causes malabsorption as well as possible nutritional deficiencies, if the right codes are used, coverage should not be a problem. And yes, it is usually the responsibility of the secretary or nurse to fill out forms with the proper codes for coverage. When it comes to medical labs and tests, they are usually prescribed to rule out possible medical conditions. ) Vicki Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 31, 2001 Report Share Posted March 31, 2001 When I had the local version of BC/BS, they paid our labs for 4 years, then one day, nope. Since they decided it was the result of a procedure that was excluded, then no, not paying for labs. Oddly, they paid Don's, not mine. Soooooooo, I shut my face. My other ins have paid them, no problem. Using chronic hypovitaminosis or chronic malnutrition might not be such a good idea for them. But hey, you are entitled to labs once/year anyway. Just those vite levels might stick in their craw. Thanks, www.vitalady.com https://secure.paypal.com/affil/pal=vitalady%40bigfoot.com lab work payments > Hi Everyone, > > I have a couple of questions. I just had my one year lab work done and it was > denied by my insurance company. The total was almost $700. When I called Blue > Cross they said that the diagnostic code said " obesity " and that is not a > covered expense. When I said they had covered the insurance and I wasn't > obese any longer they said to have the Doctor's office re-submit the bill > with a different diagnostic code. Then I called Valley Surgical. They said > it's not covered. I told them the lab would be contacting them for a > different code and explained that my B-12 level was low and was basically > told that the nurse would have to handle it. So far, no call back from the > nurse. (Personally I don't think it's the nurse's responsibility, but what do > I know.) > > OK.......now the questions. Does everyone pay for their lab work? Is it > always $700? If not, does anyone know what I can do to make the insurance > company pay? > > Thank You, > Gaylene > Dr. Boone > 3/16/00 > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 31, 2001 Report Share Posted March 31, 2001 I KNEW I liked that guy. Thanks, www.vitalady.com https://secure.paypal.com/affil/pal=vitalady%40bigfoot.com Re: lab work payments > Normally I would agree w/ Rita and Amber (they're smart cookies...um protein > cookies NOT Girl Scout cookies!). But in this area one question is > raised....Gaylene, you're self employed correct? > > I'm self employed and I'm self-insured thru Anthem Blue Cross/Blue > Shield...trust me, they nickel and dime me on everything! If you have the > Preferred plan, YMMV depending what state you have your plan in, but I've > always had to pay some amount in addition to what Anthem BC/BS deems as > reasonable charge; I've tried several appropriate submission codes. > > Bill and I are already looking into other health plans (wedding is in May so > we're looking for a family plan) but were somewhat limited to choose from > being that we both self-insure. Bill feels whatever fee I pay in addition > to what insurance pays is just a drop in the bucket for peace of mind > knowing I'm okie dokie in the lab dept. (Yeah , I can hear you > already applauding him. lol) > > O > > > > > Quote Link to comment Share on other sites More sharing options...
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