Provider billing in hospital

TDLR last paragraph. My wife went the ER and was admitted to hospital for two days. We are now starting to get bills and see claims. My wife has a plan with the following co-pays: $25 for office visits, $50 for the ER and $15 only for Teledoc. She has a $250 deductible she met back in January 2020 and her OOP max is $5000.

From my understanding if admitted to the hospital she could only be charged $50 (which the hospital is correct to bill us.) She had several encounters with doctors, every one billing and all were $0 except for one I don’t understand:

One doctor billed for code 99204 on day 1 and then 99212 on day 2. Insurance processed those as office visits and billed us $50. It seems the other encounters she had with doctors were billing 99217, 99219 or 99284.

TDLR: How can a provider bill for an “office visit” when the person is admitted to hospital?

submitted by /u/nynj2008
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TDLR last paragraph. My wife went the ER and was admitted to hospital for two days. We are now starting to get bills and see claims. My wife has a plan with the following co-pays: $25 for office visits, $50 for the ER and $15 only for Teledoc. She has a $250 deductible she met back in January 2020 and her OOP max is $5000. From my understanding if admitted to the hospital she could only be charged $50 (which the hospital is correct to bill us.) She had several encounters with doctors, every one billing and all were $0 except for one I don’t understand: One doctor billed for code 99204 on day 1 and then 99212 on day 2. Insurance processed those as office visits and billed us $50. It seems the other encounters she had with doctors were billing 99217, 99219 or 99284. TDLR: How can a provider bill for an “office visit” when the person is admitted to hospital?
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