Jan 10 2008
The CPT codes
CPT codes are procedure codes for the medical office to use in filing for their service with the insurers. And it is thicker than Webster dictionary.
Nancy from Dr. Auerbach’s office offered that they would waive one of the office visit charges since Pumpkin’s 2nd visit cost more $300. I agreed, waited for the correct bill. It never came. So I called her the other day, she sent one yesterday, with only one office visit charge. I called today, spoke with Lisa who said there isn’t a note on the file saying that the office would waived one of the charges. Ha, that’s the reason I insisted to see they put that on paper, for I don’t want this ‘waived’ charge to hunt me in the future.
Talking to the insurer, I learned that our Nov 2006 visit to ophthalmologist Dr. Diane P. Romsaitong for a check up, she charged and got paid not only for the check up ($68) but also an office visit, $133, which I did not ask for. But my insurance plan was different back then, so I was not aware. Why are the ophthalmologists are so knee on providing services that we patients did not ask for? I have never experienced it with dentists, oral surgeons, pediatricians, etc.
This episode has a little twist: the 100% covered check up is paid every 24 months. I forgot the 2006 visit. So I’m liable to pay for the 2007 visit. I’m perfectly willing to pay for the check up charge, which is why I called them repeatedly to find out, but not for the service I didn’t ask for. Dr. A’s office won’t change the CPT code, and the insurer can’t pin point how much it is. I wondered out loud, isn’t there a simple fee for the eye routine check up? The insurance agent said, “oh, no. There are many, depending one how the doctor is billing. .. .. and each doctor would have different contractual standard with us ..” So let me get this right: there are many different fee schedules for a routine eye annual check up? Right, she replied. I was bewildered: Americans are the greatest businessmen on earth. Some smart MBAs dreamed up all those redundant middlemen role and they’re profiting off it handsomely. Think of the CPT codes books are thicker than Webster dictionary! Does this lead to the bitterness of the hardworking doctors (with longer school years, even longer residency when MBAs only go for two years after college) to over charge us, or charge us without asking? Hey, don’t take it on us, the customers. If you’re bitter, fight it out with the MBAs who hold your wallet. It’s you who surrender them in the first place.