Vision and hearing

Since well child visits include hearing and vision screen as part of the visit, should we still code the vision and hearing screens. We are getting the whole claim denied just because they are coded. I think they should reimburse the well code but not completely deny the whole claim.

Wonder why we hate insurance companies???

Crap like this makes practicing medicine a pain! Coding a service even if not paid allows us to track it, run reports on those without it to call and schedule, etc. Denying the whole claim is outrageous! I would bet it is a Medicaid plan- they are the worst with making up their own rules. Talk to your provider rep.

Vision and hearing

So what I am doing is continuing to mark the superbill to document that it was done. The billing department wants me to not mark it on the superbill but document it on the chart. What should I do?

You like getting a paycheck, don't you?

so if the only way to get the visit paid is to not include the codes, then don't include them. But keep fighting with the insurer to fix their edits.

vision and hearing

You can't fight these on a claim by claim basis, but it is worth it to talk to the insurance commissioner, talk to the medical director of the insurance company, threaten to walk away from the contract, try to get your state medical society to take up the cause. The CPT book specifically says to report (i.e. bill for ) them separately.

The charge for each service isn't high, but they are performed so many times in the year.

http://www.codapedia.com/-article_249_.cfm