COLECTOMY - CODING ON HOSPITAL BILL DENIES PAYMENT

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JoJosMom
Regular Member


Date Joined Nov 2008
Total Posts : 24
   Posted 12/26/2008 5:25 PM (GMT -6)   
Help!! I had a colectomy based on MSH2 HNPCC (Lynch Syndrome) and meeting all family history.  Hospital has denied payment requesting correct coding.
 
Does anyone out there have that information?  Husband is retired, and I work (am on disability right now) for a non profit.
 
Help greatly appreciated.
 
Annie
 
PS We have BC/BS of North Carolina smhair

summerstorm
Veteran Member


Date Joined Aug 2006
Total Posts : 6571
   Posted 12/27/2008 9:43 AM (GMT -6)   
did you call the hospital billing deptartment and have them look over it again. I have had that happen with tests before. Someone just transposes a number and it gets denied.
good luck!

jujub
Forum Moderator


Date Joined Mar 2003
Total Posts : 10404
   Posted 12/27/2008 11:02 AM (GMT -6)   
I agree, the hospital needs to re-submit the bill. Medical coding is a complex, specialized area and they should have experts to do that. All it takes, though, is one number entered wrong, and the whole claim can be spit back. This is the hospital's error and they need to correct it. I'm sure BC/BS sent the claim back to the hospital at the same time they notified you.
Judy
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Avascular necrosis in both shoulders is my "forever" gift from Entocort.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. In remission since April, 2006.
"My life is an ongoing medical adventure"
 
Co-Moderator UC Forum
Please remember to consult your health care provider when making health-related decisions.


JoJosMom
Regular Member


Date Joined Nov 2008
Total Posts : 24
   Posted 12/28/2008 10:33 AM (GMT -6)   
Thank you...I have calmed down. It did not help the mail came Christmas Eve, and the billing offices are closed till tomorrow. I am such an OCD nerd about things. Finding this harder than I thought it would be, but you all sound very brave, and like you have moved on one foot in front of the other.

Again, many thanks.

PS - JoJo is my dachshund
Lynch Syndrome II (have had previous cancers related to Lynch)
Colectomy w/ileorectal anastamosis 11/25/08, clear path
 


summerstorm
Veteran Member


Date Joined Aug 2006
Total Posts : 6571
   Posted 12/28/2008 2:34 PM (GMT -6)   
i am glad you are feeling better about this!  i am sure that it coming on christmas did not help at all!
This has nothing to do with your bill, but at the bottom you wrote
 
"PS - JoJo is my dachshund"
 
and i read that over and over thinking it said, JoJo is my DASHBOARD" and i was thinking who names their dashboard? what is that about!  I can be so slow sometimes, lol.
 

JoJosMom
Regular Member


Date Joined Nov 2008
Total Posts : 24
   Posted 12/28/2008 2:47 PM (GMT -6)   
I have "chemo brain", so I totally get that. But since I have 6 adult children (is that a word?), I have to differentiate between the dog and them. My husbands dog is a sheepdog named Lillie DuFran.

When I name my dashboard, I think I better quit driving :)
Lynch Syndrome II (have had previous cancers related to Lynch)
Colectomy w/ileorectal anastamosis 11/25/08, clear path
 


peggy113
Veteran Member


Date Joined Aug 2007
Total Posts : 1998
   Posted 12/30/2008 7:07 AM (GMT -6)   
JoJosMom,

So, I'm curious... did you get the billing issue corrected with the hospital and your insurance company yet?

JJ and Summer ---- DASHBOARD... HAAAAHAAAAAAHAAAAA! That sounds like a Summer statement!!! Go figure! Thanks for the chuckle you two.
Peggy
      
Diagnosed with CD in 1979, many resections and meds
Perm Ileostomy July 1984 at Cleveland Clinic
Disease free since surgery 
 


JoJosMom
Regular Member


Date Joined Nov 2008
Total Posts : 24
   Posted 12/30/2008 11:48 AM (GMT -6)   
I got a bill from the hospital, which probably passed the EOB notice in the Christmas mail -- for now I will wait till a 2nd bill shows up, or adjusted EOB. I really can't face a conversation that has to make sense to them. Trying to explain to my primary's nurse about absence of colon and meds that are extended release in the colon was, well, like naming my dashboard!

I'm assuming neither BC/BS or the hospital will ignore over $28,000 -- and my crashing depression will lift at some point. New normal being something I will have to accept. I told my husband about the dashboard, because we are forever hearing (and reading) things with a 50+ piece of brain and are quite surprised at what things are really said.

Blessings on you!
Annie
56 year old
Endometrial cancer, hyst 1992
Invasive breast cancer, 1999 w/rad & chemo
Lacunar infarc (stroke, 8/01 & 05/02)
Benign falcine meningioma, 3/04 (watch & wait)
Bilateral mastectomy 2005
Bilateral salpingo oopherectomy & breast reconstruction 2006
Genetic diagnosis of HNPCC MSH2 (Lynch Syndrome II) (have had previous cancers related to Lynch)
Colectomy w/ileorectal anastamosis 11/25/08, clear path
 


summerstorm
Veteran Member


Date Joined Aug 2006
Total Posts : 6571
   Posted 12/30/2008 3:07 PM (GMT -6)   
you would be amazed at some of the things i think i see or hear sometimes, lol. I am full of funniness!

I really hope you get that straightened out though
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