Reading the CDA Press Consumer Guy article “Medical billing code errors,” coupled with a letter to the editor last week regarding a wrong billing code sent to PAML by Kootenai Clinic for lab work that should have been coded as a wellness visit and paid in full by insurance, has compelled me to send this letter.
In December, I had the exact same experience with Kootenai Clinic and PAML as the one noted in last week’s paper, and I too wonder how many people out there are unwittingly paying charges because of coding mistakes. Over 25 some years that I have been paying attention to my insurance’s Explanation of Benefits, my wife and I have had this problem two or three times where I was able to correct the mistake, while a few other times it was so confusing that I gave up and paid without knowing if it was right or wrong.
The highly confusing system requires constant oversight by the patient, and I’m sure there are some who pay without checking, and have been overcharged on occasion as a result. I wish there were a way to be confident with the system.