AmyCPCCPCH
Networker
Hello I am hoping someone can help me. I work for a payer and there is a cosmetic surgeon who is billing codes for procedures that were not performed. I sent the provider a letter showing CPT guidelines state that they are billing incorrectly. The provider tells me that they do not follow CPT since they are cosmetic surgeons and they are billing the patient. We have paid them for the procedures that were performed.
Has anyone ever heard of such a thing? If this is correct, then all cosmetic surgeons could just bill whatever they wanted. If anyone can offer any assistance I would be very greatful as I am sure this patient will.
I would also like to report this physician to the appropriate people, to make sure he is not billing self pay patients for procedures not performed. As his office told me they don't usually take insurance. Who could we report this physician to if he is not a provider for any insurance companies?
Thanks again for all your help.
Amy
Has anyone ever heard of such a thing? If this is correct, then all cosmetic surgeons could just bill whatever they wanted. If anyone can offer any assistance I would be very greatful as I am sure this patient will.
I would also like to report this physician to the appropriate people, to make sure he is not billing self pay patients for procedures not performed. As his office told me they don't usually take insurance. Who could we report this physician to if he is not a provider for any insurance companies?
Thanks again for all your help.
Amy