Doctor used wrong billing code, isn’t responding to my asks to fix it

So back in July, I went in for regular STD testing and everything went well without a hitch. Then I heard from my insurance that the claim would not be paid for, leaving me with a bill at almost $1000. They said the reason is because my doctor used the wrong billing code. It turns out they used the code for males up to 21, I am 23, so that was rejected by insurance. Insurance said I need to have my doctor fix the claim.

Since then, I have called the office dozens of times. I have only been able to get a hold of someone three times, and each time they said they are working on the billing correction. I leave a voicemail every time I call and no one answers. Over the past two months as I have been informed that my bill will be sent to collections by the lab, I have called the office multiple times a week and keep getting sent to voicemail. I leave a voicemail every time identifying myself, my number, my date of birth, the date of the appointment, and the issue I am having. I have never gotten a call back.

Because I haven’t been successful with calls at all, I sent written notice to the doctor’s office via certified mail that I am requesting they fix the billing code, that I will be sent to collections if they don’t, and set a deadline for the end of this month before I submit a complaint with my state’s department of health. USPS confirmed they received that letter a week and a half ago and I have not gotten any call or email from them.

What other steps can I pursue to get this bill paid by insurance? My insurance company said they cannot fix the code on their end and that my doctor has to be the one to do it. Given my lack of success in getting this resolved, Will a complaint to the department of health force the doctor to fix the claim? Can I file an appeal with my insurance showing that all my efforts aren’t working to get this fixed?

TLDR: My doctor is not responding to my calls, emails, or letters to get a claim corrected, leaving me with a $1000 bill that is going to collections. Insurance should cover the cost in full, but only if the claim is corrected by my doctor. What options do I have?

submitted by /u/pajw424
[link] [comments]So back in July, I went in for regular STD testing and everything went well without a hitch. Then I heard from my insurance that the claim would not be paid for, leaving me with a bill at almost $1000. They said the reason is because my doctor used the wrong billing code. It turns out they used the code for males up to 21, I am 23, so that was rejected by insurance. Insurance said I need to have my doctor fix the claim. Since then, I have called the office dozens of times. I have only been able to get a hold of someone three times, and each time they said they are working on the billing correction. I leave a voicemail every time I call and no one answers. Over the past two months as I have been informed that my bill will be sent to collections by the lab, I have called the office multiple times a week and keep getting sent to voicemail. I leave a voicemail every time identifying myself, my number, my date of birth, the date of the appointment, and the issue I am having. I have never gotten a call back. Because I haven’t been successful with calls at all, I sent written notice to the doctor’s office via certified mail that I am requesting they fix the billing code, that I will be sent to collections if they don’t, and set a deadline for the end of this month before I submit a complaint with my state’s department of health. USPS confirmed they received that letter a week and a half ago and I have not gotten any call or email from them. What other steps can I pursue to get this bill paid by insurance? My insurance company said they cannot fix the code on their end and that my doctor has to be the one to do it. Given my lack of success in getting this resolved, Will a complaint to the department of health force the doctor to fix the claim? Can I file an appeal with my insurance showing that all my efforts aren’t working to get this fixed? ​ TLDR: My doctor is not responding to my calls, emails, or letters to get a claim corrected, leaving me with a $1000 bill that is going to collections. Insurance should cover the cost in full, but only if the claim is corrected by my doctor. What options do I have? submitted by /u/pajw424 [link] [comments]Read Morer/HealthInsurance

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