unavidanueva
Well-Known Member
- Joined
- Jun 1, 2015
- Messages
- 78
Ok, here's a weird one. Has anybody ever heard of something like this before?
I will be having my DS with Dr. Prachand at the University of Chicago hospital. I had my first consult on May 27 -- met with the nutritionist, psychologist, assistant surgeon, and Prachand himself, in his office in the medical office building -- not at the hospital.
The claim has been processed by my HMO. I am covered for the visit, they are in network, second tier, approved referral. But instead of the standard specialist co-pay, I was charged the $250 hospital visit (ER) copay, billed under the name of the children's hospital. I called the HMO to ask them to explain it. She said, I see that you visited the doctor and weren't admitted to the hospital, but they billed it as a hospital visit, so you'll have to call them to have them submit a corrected claim.
I called the doctor's office, and they sent my call to the billing department. The physician billing department has no record of me; they transferred me to the hospital billing department. They said, there is no way to "correct" the claim because the claim is not incorrect; if you see a U of C doctor on the hospital campus, it doesn't matter if it is in the office building and not in the hospital, it will bill as a hospital visit.
Huh??? And they are billing from the children's hospital, not even the adult hospital???
And the price difference to me? A $250 hospital visit instead of a $30 specialist office visit. According to the billing rep, this will happen every time I have to visit my surgeon.
How can they do this?
I will be having my DS with Dr. Prachand at the University of Chicago hospital. I had my first consult on May 27 -- met with the nutritionist, psychologist, assistant surgeon, and Prachand himself, in his office in the medical office building -- not at the hospital.
The claim has been processed by my HMO. I am covered for the visit, they are in network, second tier, approved referral. But instead of the standard specialist co-pay, I was charged the $250 hospital visit (ER) copay, billed under the name of the children's hospital. I called the HMO to ask them to explain it. She said, I see that you visited the doctor and weren't admitted to the hospital, but they billed it as a hospital visit, so you'll have to call them to have them submit a corrected claim.
I called the doctor's office, and they sent my call to the billing department. The physician billing department has no record of me; they transferred me to the hospital billing department. They said, there is no way to "correct" the claim because the claim is not incorrect; if you see a U of C doctor on the hospital campus, it doesn't matter if it is in the office building and not in the hospital, it will bill as a hospital visit.
Huh??? And they are billing from the children's hospital, not even the adult hospital???
And the price difference to me? A $250 hospital visit instead of a $30 specialist office visit. According to the billing rep, this will happen every time I have to visit my surgeon.
How can they do this?
