Wiki insurance contracts and billing

[Karen A.]

What is considered proper practice in this situation? We have several insurance companies who vary greatly in what services they will cover. Such as a pap with an E&M visit, a surgery tray with an EMC, a family planning visit during the post partum period. Is it proper to bill every service done without thought to a specific insurance contract and let the insurance deny services as per contract? Or is proper to bill services as an insurance contract states they will be paid?
thanks, I'm learning so much from you all!

 

[armen]

I would code and bill what was performed, regardless what you have in your contract with insurance.

 

[campy1961]

I would bill everything but if you are seeing a pattern on a certain code with a certain insurance company, you might want to contact the insurance rep or insurance company themselves and get something in writting.

I don't know if your practice keeps a report on denials or not. But the higher the denials on the books the worse the report looks. Something to think about.