I’ve been back an forth between my health insurance and provider trying to get this straightened out and I’m tired. Here is my situation: I recently went for a preventative screening and to get a refill of my anti-depressants. I get my claim and the the pay for part of it, except the depression part because it was coded as “behavioral health.” The “behavioral health” part is out of network. Go back a couple of months ago, I went to see my doctor for a checkup and a refill. Those are coded the same way, but they are covered. I talked to the office manager and she says that at both appointments were coded as “behavioral health.” She was unsure why my insurance covered the visit the first time, but not the second time. She thought maybe my benefits had changed and it was no longer covered?
I call United and confirmed that my benefits did not change. The CSR said the first visit that was covered had a Primary medical code. The 2nd visit had a primary medical code of “behavioral health.” In order for United to cover my second visit, the primary code needs to be “medical.” The office manager told me that I need to find out what to change it to so it’s covered and the doctor is willling to do it.
Does this make sense? Why does the US healthcare system have to be this complicated?
submitted by /u/holy_guacamole93
[link] [comments]
I’ve been back an forth between my health insurance and provider trying to get this straightened out and I’m tired. Here is my situation: I recently went for a preventative screening and to get a refill of my anti-depressants. I get my claim and the the pay for part of it, except the depression part because it was coded as “behavioral health.” The “behavioral health” part is out of network. Go back a couple of months ago, I went to see my doctor for a checkup and a refill. Those are coded the same way, but they are covered. I talked to the office manager and she says that at both appointments were coded as “behavioral health.” She was unsure why my insurance covered the visit the first time, but not the second time. She thought maybe my benefits had changed and it was no longer covered? I call United and confirmed that my benefits did not change. The CSR said the first visit that was covered had a Primary medical code. The 2nd visit had a primary medical code of “behavioral health.” In order for United to cover my second visit, the primary code needs to be “medical.” The office manager told me that I need to find out what to change it to so it’s covered and the doctor is willling to do it. Does this make sense? Why does the US healthcare system have to be this complicated?
submitted by /u/holy_guacamole93 [link] [comments]Read Morer/HealthInsurance