Wiki office visit ?

[RebeccaB]

One of our physicians saw a patient in the office..insurance denied the claim stating patient was in patient status for the date of service,
we found out that patient is admitted to in pt psychiatric facility...

can we bill for the visit..any help/info on this much appreciated..have never come across this situation before ?

 

[twizzle]

If your physician saw the patient in the office and billed for that encounter then it shouldn't be denied unless your provider also admitted the patient to IP status. In that case they would only bill for the IP encounter not the office visit on the same date of service.

If your provider had nothing to do with the IP admit then the insurance shouldn't deny.

 

[RebeccaB]

Our provider didn't have anything to do with the admission..patient was already to the psychiatric facility
anthem bcbs denied our claim stating in pt status on the date of service, we tried to appeal with notes and they still upheld the denial