Hello! In November of 2020, I underwent a preventative birth control procedure for the removal and replacement of my birth control rod in my arm (Nexplanon), which I know is covered under the Affordable Care Act contraceptive mandate.
I have Aetna. Aetna Co-Pay Exception for Contraceptives Policy confirms and follows the ACA mandate.
That being said… the procedure was coded incorrectly. Now, Aetna says the Healthcare provider did not code it under preventative care. As such, I am being charged for an office visit although the whole procedure is fully exempt from me needing to pay any copays (per Aetna’s own policy mentioned above).
How do I go about getting the right codes?
During the procedure, the assistant confirmed this was her first time assisting on this procedure. I am confident it was her unintended oversight.
Any pointers for how to go about fixing this?
Thank you for reading and any tips you may have!
TLDR: Hospital miscoded procedure and I need to make them recode it to preventative birth control so my insurance fully covers it but I don’t know how.
submitted by /u/Anadesea
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Hello! In November of 2020, I underwent a preventative birth control procedure for the removal and replacement of my birth control rod in my arm (Nexplanon), which I know is covered under the Affordable Care Act contraceptive mandate. I have Aetna. Aetna Co-Pay Exception for Contraceptives Policy confirms and follows the ACA mandate. That being said… the procedure was coded incorrectly. Now, Aetna says the Healthcare provider did not code it under preventative care. As such, I am being charged for an office visit although the whole procedure is fully exempt from me needing to pay any copays (per Aetna’s own policy mentioned above). How do I go about getting the right codes? During the procedure, the assistant confirmed this was her first time assisting on this procedure. I am confident it was her unintended oversight. Any pointers for how to go about fixing this? Thank you for reading and any tips you may have! TLDR: Hospital miscoded procedure and I need to make them recode it to preventative birth control so my insurance fully covers it but I don’t know how.
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