This is why I love it here. I’m showing this to my boss tomorrow. I don’t back down, Thin Man, not with these creeps. You are going to pay these claims for our patients, especially if I KNOW that it’s a “clean claim,” no issues with coding, the patient’s policy is up-to-date & paid accordingly and proof of coverage is current, I don’t want to hear anything but, “We are sending the claim back down for review and reconsideration for payment.”
If I don’t, I appeal, a second time, if needed. They still don’t pay, I correspond with the North Carolina Department of Insurance. They know me by name there. We have an insurance carrier that we’ve had to pretty much shoot through the ringer because their policy clauses for a number of new plans that rolled out this year, reduce reimbursement, paying at a Medicare rate or a Medicare rate increased by 200% for anesthesia providers. Plainly put, they don’t wanna pay us what they should.
“Ain’t nobody got time for that.” I’m like Mos Def, “Eff You, Pay Me.” I try to get it all done on my end so the patient isn’t bombarded with the triteness presented on behalf of their insurance carrier. It’s a “cold world out here.”