Well, I am back in my office from a very long two (2) week trip from teaching a couple claims and billing seminars and meeting with a new client. Exhausted from the trip, but excited about getting back in the swing of things of processing patient's paperwork, insurance, yada...yada...yada.
I've spent the last couple of days verifying numerous patient's insurance, which requires a lot of time on the telephone. I find it very interesting that most insurance companies no longer tell you if a particular HCPCS Code is covered under the patient's insurance plan; therefore, it is imperative to probe and ask additional questions to the "customer service advocate" so you give them very little room to deny a claim for payment.
I find it somewhat of a joke that insurance companies fail to provide explicit details to the patient's medical coverage, when requested by the caller...which is me. I believe it can be considered a "trick" if you don't ask the right questions.
Sad thing??? Many times providers and their staff do not know what specific questions they should be asking the insurance company pertaining to their services, products and/or medical devices.
Worse than that??? A patient receiving a statement from the provider for payment on services that may not have been covered, and the patient may not have been notified in advance that these services may be denied.
Gotta stay on top of your game...the insurance companies are!!!