Good Morning,
I am looking over a hospital bill for someone and I am not very familiar with facility billing so I was wondering if someone could help me. The pt. had a Colonoscopy done and my first question was I know facilities do not bill cpt codes, but how does the insurance company know what's being billed? On her itemized statement there are numbers, 6-9, but on the EOB it just says drugs, supplies, operating room, etc..... How does the insurance company know that they are not being over charged?
Also, I noticed on the itemized statement it says "Surgical Path Level 4" 3units, I presume, $502.98, but then the patient received a bill in the amount of $502.98 from the Pathologist as well. I know that the specimen has to be taken and then read, but I guess why I am questioning it is because it is for the same exact price.
Also, in order to learn facility billing would I have to take a facility coding course? I know for physcian billing you can take a physicain based billing course and if you wanted to learn physician coding you could take a physician based coding course. But I am not sure when it comes to hospital billing.
Any clarification would be greatly appreciated.