Author Topic: Workers' Comp and Incorrect Dx  (Read 1736 times)

epitome

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Workers' Comp and Incorrect Dx
« on: May 11, 2012, 10:46:25 PM »
Hello,

I was a patient of a doctor under a federal workers' compensation claim. I was approved by for a specific diagnosis, but when I visited my physician he billed my initial office visit under a similar ICD-9 (but "not related" according to the government) until diagnostic tests were returned. The tests confirmed my approved diagnosis and we moved forward with treatment without any trouble with billing, but the billing office continued to get rejected for the initial office visit due to billing under an non-approved ICD-9.

Now, years later, the billing department is coming after me for the charge. I presented the billers with my workers' compensation claim and all paperwork relating to my case during the first visit. The doctor, I understand, I was uncertain of my diagnosis and ordered more testing, but submitted the note before a definitive diagnosis was returned.

Do I have any recourse here? I've asked the billing department to annotate the original note to support billing, but they say that is not possible. The doctor eventually diagnosed me correctly and got paid for everything else, so I don't understand how the billing department can't return the original note for a basic annotation correcting the diagnosis.

Any feedback would be appreciated. Thank you!
« Last Edit: May 11, 2012, 10:50:19 PM by epitome »

Michele

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Re: Workers' Comp and Incorrect Dx
« Reply #1 on: May 13, 2012, 04:08:29 PM »
I would call your state workers comp office and ask if the provider can hold you responsible for the bill.
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