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$30,000 Pharmacy Claim Reduced to $0

August 7, 2015

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Insurance Billing Issue Resolved

August 7, 2015

Theresa was billed $615 from a physicians group. She was concerned because typically she pays a small copay for office visits. We were able to confirm that the insurance never received the claims. We contacted the billing department and they in turn filed them with insurance for processing. The good news is the claims were both reprocessed, but upon looking at the patient’s Explanation of Benefits (EOB’s), we noticed they were stating patient responsibility was a $40 copay for each claim, but In-Network office visits should only be $20. We were able to have the insurance pull the claims to be reprocessed correctly and then we called the billing department to prevent them from asking Theresa for more money.

 

Not only did we save client $615 due to billing error, but then we were able to save her $40 in a processing error as well.

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