Insurance won’t cover refered physician’s referral

Hey y’all, I have a question and any help would be much appreciated. If I’m not doing this right or it needs to be fixed, let me know.

Short story, I was referred by campus health center(whom I had insurance through) to a uro-gynocologist, for incontinence even though I expressed that I was concerned about pelvic floor dysfunction(which was noted on referral) and asked a for a pelvic floor physical therapist. Anyway, I go to the uro-gyn, and they refer me to a physical therapist (go figure.)

About a week after my insurance runs out(which I planned for and stopped going to PT before) I receive a bill that reflects more than twice what I should owe. Eventually I call and they say insurance wasn’t covering it. I call insurance this week, and they say that I’m being charged a referral penalty because the diagnoses codes on the school referral doesn’t match the codes from the refered physician that I was referred to by the school. So, the insurance says to have the school put on the diagnosis codes sent to the PT. School says they can’t backdate referrals per contract with insurance. Insurance says they need a backdated referal and they’ll accept. Any suggestions on what to do from here?

I can’t really pay the over $500 bill. And no one from the school health services told me if I get a seperate referral I would need to show them so they can approve it, otherwise I would have.

*Side rant: I don’t even know why she didn’t just send one to a PT in the first place.

submitted by /u/brain-skull-rest
[link] [comments]Hey y’all, I have a question and any help would be much appreciated. If I’m not doing this right or it needs to be fixed, let me know. Short story, I was referred by campus health center(whom I had insurance through) to a uro-gynocologist, for incontinence even though I expressed that I was concerned about pelvic floor dysfunction(which was noted on referral) and asked a for a pelvic floor physical therapist. Anyway, I go to the uro-gyn, and they refer me to a physical therapist (go figure.) About a week after my insurance runs out(which I planned for and stopped going to PT before) I receive a bill that reflects more than twice what I should owe. Eventually I call and they say insurance wasn’t covering it. I call insurance this week, and they say that I’m being charged a referral penalty because the diagnoses codes on the school referral doesn’t match the codes from the refered physician that I was referred to by the school. So, the insurance says to have the school put on the diagnosis codes sent to the PT. School says they can’t backdate referrals per contract with insurance. Insurance says they need a backdated referal and they’ll accept. Any suggestions on what to do from here? I can’t really pay the over $500 bill. And no one from the school health services told me if I get a seperate referral I would need to show them so they can approve it, otherwise I would have. *Side rant: I don’t even know why she didn’t just send one to a PT in the first place. submitted by /u/brain-skull-rest [link] [comments]Read Morer/HealthInsurance

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