Author Topic: Advice- My hubby's drug rehab facility won't do UB92 as Insurance requires  (Read 1049 times)

Nanette

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Hi-- I,m not sure if this is the forum I need but I am grasping at straws for advice.  My husband was in drug rehab for 60 days, which is covered and allowed by his insurance.  The billing they sent to insurance was more like a letter than any kind of "coded" billing I have seen.  I have spoken to them at least three times asking for more than this but they respond they do not have the capacity  (staff, expertise, etc.) to provide more detailed billing.  Is it ever possible to hire a freelance biller to code this up for me?  It is a large bill, cost of brand new compact car, that I really hope to be reimbursed for.  My insurance company is very good and cooperative but I believe they are waiting in vain for details they will never receive from this facility.  Thank you anyone who can help.

PMRNC

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You can't hire someone freelance as they don't have the medical records. The facility is OBLIGATED by law to provide detailed billing. Are you sure this was pre-certified by your insurance? If so contact them and let them deal with them and tell them they are not giving you a detailed billing. Outpatient drug/alcohol often has to be pre-certified and the facility has to be accredited and they too are given the authorization. Only problem I can see is if he went in, did not pre-certify and the facility does not do insurance billing, I know there are some that are not affiliated with any insurance companies (few).
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Nanette

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Thank you.  I did ask his doctor at the hospital to contact the insurance company.  The doctor said he did.  I may be jumping the gun.  I hope the insurance company can work it out with their billing department.  The insurance company has never said they will not pay , they are just seeking more details.