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ambar1116

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The physician I work for is out of network with Coventry Health Plan, one night he was on call and he was called in to perform a surgery on a patient that was seen in the ER Department. The old coder billed 99223-25, 11012 and of course the claim denied, not even the hospital got paid. Was this the correct way of billing this claim? Please help I'm not a coder but the office manager but I believe these procedures were billed correctly. Please advise.
Thanks in advance! :)
 
Appeal the out of network as this was an emergency procedure, not an elective surgery. Call Coventry and raise a ruckus. Also have the insured (patient) call and complain as well...otherwise, the patient will have to foot the bill.
 
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