Home Forums Hunting & Shooting Hunter's Campfire Anthem declines claim for woman's valid reason to ER

My girlfriend has run coding and billing for hospitals and doctors. She hates insurance companies and over billing medical providers. She told me that unlike dentists and vets doctors and hospitals have to offer a payment plan. She recommends that if they are pulling over billing and endless bills ask for a payment plan. When they ask how much you can afford per month tell them ONE DOLLAR.
Also she claims many of the billers and coders are dumb as rocks and make mistakes all day long.

Went to ER and they ran a CAT scan which found a kidney stone about to pass into my bladder was the cause of excruciating pain on right side. Was on Medicare and Blue Shield PPO, claim was denied by both. Wife worked as claims assistant for 16 years with a commercial insurer, tracked denial down to a one digit error in the billing code, where the visit was billed as in-patient, as if I had been admitted, but the CAT Scan and rest was billed as out-patient. That conflict sent the system into a tizzy. Nobody seemed to know who to talk to to resolve the issue. Eventually we both returned to the hospital, found the I.T. manager, explained what happened, showed him the documentation, and he said, OOPS! and changed the billing as we waited. If we weren't retired and had the time to investigate we may never have had that hassle resolved.