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.
A Cornered Gurl 
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