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LMichele
LIF Adolescent
Member since 6/11 573 total posts
Name:
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GHI Billing Question
It may be a long shot, but my gyno's office isn't open until Monday and in the meantime I'm freaking out that I owe $500!
I had a transvaginal and pelvic sonogram done at my annual exam. I have PCOS and had been feeling some strange cramping, so my gyno decided to have both done just to check everything out. Everything was fine, thankfully.
I just got the bill from the gyno's office. Each sono was charged $500 to GHI. They covered all but the $20 co-pay for the transvaginal sono, but the pelvic was showing that I owe $500.
I called GHI and they said they didn't see any claim for the pelvic sono, so it's possible it didn't go through. They also said not to pay the gyno until I get something from GHI saying what was covered.
I'm hoping it's as easy as the claim didn't go through.
BUT, the GHI rep also said she isn't sure if both sonograms can be covered if they're done on the same day.
Could this be true? I've had both done on the same day before with GHI and they were covered.
TIA
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Posted 9/10/16 7:33 AM  |
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BabyHopes2
LIF Adult
Member since 4/13 1058 total posts
Name:
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Re: GHI Billing Question
Are you sure this isn't a statement of claims? That sounds bizarre, I wouldn't worry must be a billing error. I was in a fertility clinic and had sonos all the time never was billed for it and I have GHI too.
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| Posted 9/10/16 11:21 AM |
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BabyLove08
Love her!
Member since 2/08 3673 total posts
Name:
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GHI Billing Question
I have GHI and when I recently went for my annual and needed a sono to check something they told me GHI won't cover them both being done on the same day so I had to make two appointments.
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| Posted 9/10/16 1:05 PM |
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LMichele
LIF Adolescent
Member since 6/11 573 total posts
Name:
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Re: GHI Billing Question
Your annual and sono couldn't be on the same day, or both sonograms couldn't be on the same day?
I had my annual a week prior to the sonogram appointment, but both sonograms were done on the same day.
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| Posted 9/10/16 2:33 PM |
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LMichele
LIF Adolescent
Member since 6/11 573 total posts
Name:
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GHI Billing Question
Ugh! I just checked my GHI account online and you are right..there was this note next to the second sonogram..
1.The payment was already made for a similar service/procedure on the same date under another claim number.
I am PISSED. No one at my gyno's office mentioned this to me, and I cannot pay the $500 right now!
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| Posted 9/10/16 2:38 PM |
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jessnbrian
Only God knows His plan for us
Member since 4/13 7238 total posts
Name:
Jessica
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Re: GHI Billing Question
Posted by LMichele
Ugh! I just checked my GHI account online and you are right..there was this note next to the second sonogram..
1.The payment was already made for a similar service/procedure on the same date under another claim number.
I am PISSED. No one at my gyno's office mentioned this to me, and I cannot pay the $500 right now!
Wait to speak with the doctors office. It sounds like GHI is bundling the codes, which is NOT something you would be responsible for. So say they paid $x for the one sono and denied the other saying it was previously paid inclusive to a previous procedure, that is not something you would have to pay for.
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| Posted 9/11/16 8:41 PM |
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jessnbrian
Only God knows His plan for us
Member since 4/13 7238 total posts
Name:
Jessica
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GHI Billing Question
Just wanted to add : that is all only if your gyno AND the sono facility are IN network with GHI, if you see them out of network you could be responsible.
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| Posted 9/11/16 8:42 PM |
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LMichele
LIF Adolescent
Member since 6/11 573 total posts
Name:
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Re: GHI Billing Question
Posted by jessnbrian
Posted by LMichele
Ugh! I just checked my GHI account online and you are right..there was this note next to the second sonogram..
1.The payment was already made for a similar service/procedure on the same date under another claim number.
I am PISSED. No one at my gyno's office mentioned this to me, and I cannot pay the $500 right now!
Wait to speak with the doctors office. It sounds like GHI is bundling the codes, which is NOT something you would be responsible for. So say they paid $x for the one sono and denied the other saying it was previously paid inclusive to a previous procedure, that is not something you would have to pay for.
Exactly this. I called GHI and was told everything you said.
My gyno's office told me "We have 5,000 patients and it's not our responsibility to know each and every policy" and want the money.
I called the office back after speaking with GHI and was told by the woman in billing that she was willing to bill me $150 of the $500, but since I had called GHI she was going to resubmit the claim and notify them to charge me the full $500. As if it were a punishment for me calling GHI to question charges that I didn't think were accurate and wanted explained.
Unfortunately, my gyno's office knows what they are doing and had me sign a waiver saying that I would pay any charges not covered by insurance. I specifically asked before signing if they were covered and was told "yes" by the office, and when I relayed that to the woman in billing I got her "we have 5,000 patients" response and was told the fact they told me yes means nothing since it's not their responsibility.
I called GHI again and they said had I not signed the waiver, I wouldn't be responsible for paying anything over the $20 co-pay since it's an in-network provider with a contract with GHI. But because I had signed the waiver, there's unfortunately not much they can do for me other than filing a quality complaint for service against the doctor's office.
I called back the gyno's office and spoke to the office manager and was told the waiver I signed says I agreed to pay $150, and cannot be charged the full $500.
Regardless, I'm not paying anything until I receive notice from the insurance.
Message edited 9/12/2016 11:18:15 AM.
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| Posted 9/12/16 8:27 AM |
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