Invoices

Invoices

rick

4/2/2004

Dear List,

 

I have recently received and EOB from an insurance carrier who has paid
part of an invoice for a prosthesis but has excluded payment for several
codes. Before they will pay for the codes in question they are
requesting an invoice or documentation of cost before paying for the
codes in question. One of the codes is the base code L5301. The other
two codes are components that have corresponding invoices. We received
authorization ahead of time, but as usual that does not guarantee
payment. My first response is that these insurance companies have no
right to look at my invoices. I also realize that if I don't give them
something they will deny payment. What experience do people have with
this and what did you do to get an appropriate reimbursement. To me this
is a very dangerous situation where insurance companies will now
determine what our profits will be by what we pay for components without
compensation for the skill, knowledge and time it takes use the
components. To me this is totally absurd; do I have a right to ask them
for invoices for my premiums and then pay what I feel like is
appropriate for the invoice? Isn't it ironic that while my healthcare
premiums are skyrocketing my reimbursements are plummeting? Am I alone
in thinking that someone out there is making some significant money on
the spread.

 

Rick Stapleton, CP