Owe St. Joesph's over $9,300 thanks to Code Mistake

Discuss here about Medical Disability claims and Insurance possibilities for PN treatment options

Re: Owe St. Joesph's over $9,300 thanks to Code Mistake

Postby nyt » Thu Dec 19, 2013 3:27 pm

Rea, Yippee!! I am so glad to hear this.

I'm still dealing with my bill from the hospital and Dr. Hibner's office from back in March. My insurance paid for all of my hospital bill except the actual botox which is $4,000.00 They denied payment because Dr. Hibner injected my piriformis along with my pelvic floor muscles and adductor muscles to my legs. That was the only thing different compared to all the other times, which they always paid but said the piriformis was experimental. They approved the code for the chemodenervation, paid for the OR room, recovery room, etc. but not the actual botox. How crazy is that. I am waiting to hear about the appeal.

I think the bill to Dr. HIbner is finally resolved and I should get the money back I paid upfront in the next 3 weeks. At least I better or I told the doctor's billing office I was going to the attorney general. My insurance company regarding both of my bills have been really great to work with esp. my bill to Dr. Hibner. Dr. Hibner is a participating provider with my insurance and come to find out it is a breach of contract for them to have me pay upfront. My insurance company is in the middle of working out who made the determination that I needed to pay upfront and to make sure that anyone who participates doesn't pay upfront. If your insurance participates with Dr. Hibner's office you might want to check with your insurance company to make sure that Dr. Hibner's office can bill you upfront.
2/07 LAVH and TOT 7/07 TOT right side removed 9/07 IL, IH and GN neuropathy 11/07 PN - Dr. Howard
6/08 Obturator neuralgia - Dr. Conway 11/08 Disability, piriformis syndrome - Dr. Howard
4/09 Bilateral obturator decompression surgery, BLL RSD - Dr. Howard
9/10 Removed left side TOT, botox, re-evaluate obturator nerve - Dr. Hibner
2/11 LFCN and saphenous neuralgia - Dr. Dellon 2/11 MRI with Dr. Potter - confirmed entrapment
5/11 Right side TG - Dr. Hibner 2012 Left side TG - Dr. Hibner
nyt
 
Posts: 1154
Joined: Sun Oct 31, 2010 3:24 am

Re: Owe St. Joesph's over $9,300 thanks to Code Mistake

Postby rea » Fri Dec 20, 2013 1:00 am

Yea for you too..all it takes for ins. Companies to get out of paying is the wrong coding. But I thought if a network provider doesn't pay for something, then the patient cannot be held responsible for that amount. It happened with pm. They did a nerve conduction study that wasn't pre approved. My insurance wouldn't pay and I was told by my ins, that pm couldn't make me pay. Well, over a year later, pm resubmitted the claim, changed the codes to xrays, and got paid. Never had xrays there!
The hospital billing for my first office visit is still messed up. I paid the cash option but since insurance was billed on my second visit, they sent the bill through again. They said I owed them but after sending in my receipt twice, haven't heard a word about it. They actually owe me a refund! Won't hold my breath. I really hope everything gets settled and refunded. Hibner's not in network but they did a waiver for 1 year. Don't think I'll be going back to see him. Merry Christmas!
Symptoms began 6/27/12. Diagnosed with Vulvodynia.Estrace and Lidocane with no relief.
Uretha enlarged Aug. 2012. MRI of Lumbar in Sept. 2012.Normal. Did MRI 3 Tesla of ischial spine to Sacro Spin- Normal. Houston-Nerve Block 10-31-12 & MRI (MRN) entrapment of perineal branch, more on right side. Dr. Hibner- block of perineal branches and sclerozation w/relief over 1 month. SIJD/Piriformis Syndrome Left Side. Gabapentin 2400 mg.
rea
 
Posts: 123
Joined: Fri Sep 07, 2012 8:16 pm
Location: USA

Previous

Return to INSURANCE & DISABILITY ISSUES

Who is online

Users browsing this forum: No registered users and 1 guest