Have a patient who came to urgent care with Kaiser Permanente insurance. Patient is 87 yrs old. Patient had New patient exam, and toradol injection. The insurance reimbursed the office visit and the administration , but did not reimburse for the medication. The explanation of benefits stated this drug/supply is not included in the fee schedule or contracted/legislated fee arrangement.
My billing supervisor is thinking that Kaiser should be reimbursing following Medicare guidelines. Please advise.
Thank you
Paula
My billing supervisor is thinking that Kaiser should be reimbursing following Medicare guidelines. Please advise.
Thank you
Paula