Really frustrated; hoping Reddit can help—please let me know if there’s anything I can do! For reference, I have Anthem Blue Cross.
I had my bilateral salpingectomy a few weeks ago (CPT code 58661, diagnostic code z30.2). It’s a sterilization surgery, 100% covered under preventative care. During my operation, however, my doctor discovered a benign ovarian cyst and removed it, adding an additional 58662 code.
I just received my claim and I owe almost $2,000. I called insurance and they said the 58661 code processed and I don’t owe anything for that, and what I’m paying is for the 58662 cyst removal. I obviously didn’t get to approve this, since I was under during the operation. The insurance person I called suggested that I can try and appeal the claim. Do I have grounds for this? Has anyone experienced this before, and were you able to dispute the claim?
Another question I had was related to my pre-op lab tests. The doctor ordered blood tests for this procedure that I’ve confirmed is 100% covered, yet for some of the labs, this was not the case. Insurance said that’s just what it is, some of the lab test codes aren’t covered. Is this allowed? Like I have to get these tests for a preventative surgery that’s supposedly 100% covered under the ACA, and then I have to pay for them…
Anyway, thank you for any advice or tips you can give me!
submitted by /u/nyomnyomnyommm
[link] [comments]Really frustrated; hoping Reddit can help—please let me know if there’s anything I can do! For reference, I have Anthem Blue Cross. I had my bilateral salpingectomy a few weeks ago (CPT code 58661, diagnostic code z30.2). It’s a sterilization surgery, 100% covered under preventative care. During my operation, however, my doctor discovered a benign ovarian cyst and removed it, adding an additional 58662 code. I just received my claim and I owe almost $2,000. I called insurance and they said the 58661 code processed and I don’t owe anything for that, and what I’m paying is for the 58662 cyst removal. I obviously didn’t get to approve this, since I was under during the operation. The insurance person I called suggested that I can try and appeal the claim. Do I have grounds for this? Has anyone experienced this before, and were you able to dispute the claim? Another question I had was related to my pre-op lab tests. The doctor ordered blood tests for this procedure that I’ve confirmed is 100% covered, yet for some of the labs, this was not the case. Insurance said that’s just what it is, some of the lab test codes aren’t covered. Is this allowed? Like I have to get these tests for a preventative surgery that’s supposedly 100% covered under the ACA, and then I have to pay for them… Anyway, thank you for any advice or tips you can give me! submitted by /u/nyomnyomnyommm [link] [comments]Read Morer/HealthInsurance