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Originally Posted by rahl
Like I said, hospitals have to process hundreds of claims each day, when dealing with so many codes and so many patients sometimes they get screwed up. It's not your fault, it's not the insurance companies fault. But if a claim comes in and it's incorrect what are they supposed to do?
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I refer you back to my previous comments-
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"This codes wrong, should be out patient.... denied" "Forms states patient is female, insured is male... denied." Form states procedure preformed on right shoulder, pre-approved for left... denied." And on and on. Once it's denied getting it not denied is like putting toothpaste back in the tube. Like some circle jerk from hell. "Oh, yes we'll just change the code." "Oh, that? That's an obvious mistake we'll change it. Don't worry about it." Two months later you're getting a letter and call from a collection agency.
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First the codes are so difficult to understand even the people who do it for a living are getting them wrong... repeatedly. Hmm, now who would have an interest in making this confusing? I mean who would benefit if a claim was erroneously rejected for payment?
Second if, as I stated above, you contact the policy issuer and are told "Oh, that? That's an obvious mistake we'll change it. Don't worry about it" that should be the end of it. But I had this happen repeatedly and that was never the end of it. Again once it was denied getting not denied was like putting toothpaste back in the tube.
Third, the application may be a few pages with simple questions but the last policy I had filled three booklets, the shortest was about 25 pages and I think it discussed what was and wasn't covered regarding mental health care. After reading all three books I felt like filing a claim for some mental health care.
Finally I'll just quote ratbastid-
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Because insurance companies in general are doing that like crazy. If yours doesn't, then either you don't know about it (because really, who would tell the whole staff about your evilness?), or your company is the one saint in the cesspool.
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