By Marc Manor
Those of us old enough to remember “Gomer Pyle”, can visualize
the scowl on Sergeant Carter’s face when Gomer revealed his many
surprises! Surprises can be great but
not when it comes to healthcare insurance claims, most of us want to our bills
to be exactly what we expect – NO SURPRISES!
Healthcare insurance claims are based on a long list of
medical codes that are associated with each treatment, diagnosis, and/or
medical procedure. The codes are
entered by medical data entry people to base them on a patient’s chart or
doctors notes. The codes have a variety
of uses in the medical field but the codes that are probably most important to
us as healthcare insurance beneficiaries are the ones correlated to our
healthcare benefits. The codes submitted
to the insurance company will determine how claims will be processed. Allow me to provide you with some examples
that may help in understanding how the codes affect healthcare insurance
claims:
“I received a bill for a recent lab test. I thought lab tests associated with qualified
preventive care was 100% covered!”
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