News

Actions

Medical coding error sparks two year fight to get bill paid

Posted at 3:59 PM, Feb 01, 2017
and last updated 2017-02-02 11:26:46-05
Just hear the words 'dentist', 'pulled tooth', and 'infection' and you're likely cringing.
 
Add insurance trouble and you have Cynthia Morquecho's long, painful story.
 
Cynthia had a tooth pulled and says the dentist left part of the root still in her mouth. She says he also punctured her sinus cavity.
 
With infection and pain, she went to Banner Good Samaritan's Emergency Room -- two years ago.
 
Ever since then, Cynthia says she's been fighting to get her $7000+ bill paid by insurance.
 
She says while the ER visit was a medical procedure, it was coded as dental. So, she says, her Medicare provider wouldn't pay.
 
Cynthia says she could only pay $810 towards the amount, was sent to collections and then she let me know.
 
The Assistance League of Phoenix volunteer team went to work.
 
Volunteer Carol took the case, went over Cynthia's paperwork and talked to the people at Banner Health.
 
In just a few weeks, Cynthia's years-long battle was over. Not only did her insurance pay the remainder of the bill, they reimbursed Cynthia for the $800+ she had paid.
 
"I was so relieved. That was a weight off my shoulders," Cynthia said.
 
Banner says: "The coding on a patient’s bill is based on the physician’s documentation in the patient’s medical record. This helps us appropriately bill the patient or the patient’s insurance company. If, for any reason, a patient believes a medical coding issue has occurred in their billing, they should contact Patient Financial Services for assistance. While coding issues are very uncommon, it is important to ensure accuracy. "
 
Thanks to Banner for taking care of this.
 
We can help you, too.
 
The Assistance League of Phoenix volunteers are solving consumer problems and saving you money every day.
 
You can call them at 1-855-323-1515 or send an email.
 
"Like" the Let Joe Know Facebook page and tell me about the issue there.
 
You can also follow us on Twitter.
 
Check out the latest scams we're seeing. Sign up for our monthly email newsletter by clicking here.
 
AND WE NEED YOUR HELP!  If you want to be a volunteer and help other consumers, let me know.