I say this as a person who has been in the medical field for 23 years, and who was a medical biller for 10 of them.

Earlier today, I had to place a call to my insurance carrier and have them call the billing department for my provider’s office because I have been billed twice for services rendered on the same date.
Disclaimer: I had one appointment on the date mentioned below, and it was for my annual exam only, which is a service covered at 100% by my insurance plan.
I went for my annual exam on 02/18/25 and my provider’s office coded the actual annual exam, it was processed and covered at 100% and paid accordingly, but they also billed me for a 99214 code which is the second to last CPT code for an established patient office visit. One of the highest billed charges for an established patient for in-office services.
Now, I know these people didn’t think they’d get someone who did medical billing for 10 years calling them today with a representative from their insurance carrier, but they got the WRONG one and the RIGHT one today.
My insurance representative informed the billing representative who took the call that they will need to send a corrected claim to reflect the annual exam only (which means, they’re going to end up having to refund the payment for that OV (office visit) code they billed incorrectly, too) and the bill I received from them for $30.00 is currently being held or contested until after the coding review.
I don’t play when it comes to my bills and you DARN sure ain’t gon’ get me because I scrutinize every EOB that is emailed to me. And I do so happily because I have seen way too many people pay bills without actually reviewing them and matching them up with their insurance policy’s coverage and benefits.
People, please review your healthcare bills with a fine-toothed comb. Ensure what you receive is correct and on par with what YOU KNOW is in line with the services rendered.
I was informed I should receive an updated bill and resolution in 7 to 10 business days.
My inner Ghetto Queen is saying, “BAYBAY, I will R O L L up to their corporate office at the hospital and ACT A WHOLE FOOL over $30.00. You not gon’ get me for preventative services that’s covered at 100% with my plan. Nah, nah. You remove that OV code, send a corrected claim, and give my insurance carrier back their refund when it’s all said and done. And don’t do it, and watch me email the CEO of that hospital organization.”
Be on the lookout, beautiful people. Take care of yourself and make sure no one is taking advantage of you and your medical benefits. It’s only going to get worse as time moves forward under this current administration. Mark my words. Stay vigilant, loves.
This is especially true when it comes to hospital bills.
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Thankfully, I haven’t had one of those in about 15 years. And I can only imagine!
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They absolutely had the right one and didn’t even know it 🤣
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BAYBAY! That part! I had all my notes and information at the ready, and called them with my insurance representative on the line. We gon’ have an audial witness; one who can look at my claim and actually say, “No, this isn’t right. Which service is it? You have to file the claim for that service only.” Lol!
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Girl, this has tickled me so much.
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🤣😂😆
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This is very good advice. I’ve had to query stuff on many occasions, and.thankfully I had a friend who did the same job. She’d sort me out in a jiffy. But they be testing you and trying to slip one past you a lot of times.
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Exactly. They do. And they succeed a lot because most people will just pay it and keep it moving. Not me. 😆🤣😂
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😅🤣
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Oh how I LOVE your inner Ghetto Queen trE! 🤜🏼🤛🏼 Thanks so much for the warning. We just went through something similar over the past year. My husband allowed his Ghetto King to come out! 😂😱🤣 They didn’t accept our calm, intelligent approach, so we haven’t heard from them in a few months! 😜 We’ll see!
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Exactly! It’s like, listen I’m being nice right now, don’t take me there. Lol.
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Okay! 🤜🏼🤛🏼
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amazing
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Thanks for the heads up!
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🙏🏾🩵
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Great
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Thank goodness for the NHS!
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Great advice to heed. Thank you
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You’re welcome. Thank you!
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Hope it all gets settled correctly.
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I do as well. I don’t want to have to make another phone call or go to the centralized billing office. If people just did their jobs, this would not have happened. 🙏🏾🩵
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Good for you that you were on it~! 🙌🏽
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Yes, ma’am!
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Listen!!😂😂😂 Don’t roll up on them!😂😂😂 You have made me laugh tonight! Have a great night trE. Job well done.👏🏽👏🏽👏🏽😂
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😂🤣😆 Shaun, sometimes I have ZERO sense. I’m slightly serious, though. Lol. I hope you’ll have a great night as well.
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😂😅 And thank you!
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Good job! Thank you for sharing your experience and expertise with us.
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You’re welcome. I wish I didn’t have to, but these are things that happen, unfortunately. 🙏🏾🩵
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Yes, it seems to be a thing with several billing situations, beyond medical. Unfortunately, yes.
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Yikes! That’s good advice that I will absolutely be taking!
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You must stay on top of it. *Sighs* It really is sad what healthcare has become in this country and it breaks my heart.
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I agree! Reminds me of the time I got a $300 bill from an urgent care I saw. They didn’t even run my insurance even though I gave them my information. I called their 800 number and complained and never saw another bill. Like, how do they get away with not even attempting to run my insurance and sending me a bill for the whole amount? The audacity!
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I’ve had that happen before, actually the most recent time was last year. The way I cut up on those folks after being nice for the first 15 minutes of my interaction with them and the representative kept trying to tell me I didn’t have active coverage should be a crime.
I pulled up my coverage and eligibility and emailed that person directly and already had a screenshot of the chat conversation from a representative from my insurance carrier detailing and confirming my coverage.
By the time I was done with that representative, my claim was sent back for reprocessing and paid accordingly and they ended up owing me money for overcharging me at check-in.
I politely called them about ten days after I received my EOB to allow time for them to get their payment from my insurance carrier and apply it to my account, and I hit them up for my refund. 😂🤣😆
I know they don’t like me and I don’t care. You’re not going to take advantage of me and I mean that. Lol.
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They probably aren’t used to dealing with people who pay attention and know what is expected and what’s not.
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💯💯💯
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