Posted by Ritch on January 21, 2005, at 9:47:21
In reply to Psychiatrists (and others) please read, posted by Jakeman on January 20, 2005, at 23:54:03
>...My Dr. had submitted claims under code 90805: individual psychotherapy and medical management services- 20-30 minutes, and Code 90807, same services, 45-50 minutes.
When I finally got to see him I confronted him about it, in that I had never received psychotherapy, and I never had an appointment over 30 minutes. His immediate response was that those were the codes that he used but he could refer me to another physician who just does "medication management" (Code 90862).
...There's more to this story but this is already too long. Does anybody know if I have any recourse for his inaccurate coding and submission of claims (because of this I owe about $600 out of pocket).
Ummm, isn't that defrauding (unintentional?) the insurance company? Instead of bringing it up to him directly, try his receptionist... maybe if you talk to one of his staff that is responsible for filing the claims you can get it straightened out. Just a thought, but if you don't spend any quality time with this guy anyhow, maybe you would be *no worse* off with someone who does just "medication management"? Get your money back from his staff though.. if you let them (the staff) know that the insurance company has been overbilled and you don't know how to solve the problem and you think you might have to contact the insurance company about it.. you might get things straightened out.. and then find someone else quick.
poster:Ritch
thread:445031
URL: http://www.dr-bob.org/babble/20050119/msgs/445159.html