Insurance would not pay for ultrasound to diagnose miscarriage! Sooooo angry!

[Anonymous]

I am in the similar situation. I am currently 20 weeks pregnant and had a routine ultrasound on 09/25. I have a HSA account with aetna. Today while just browsing y insurance website, i was shocked to see that i had been chared $945+$140 for the ultrasound, which is not covered by the insurance. Since i have autopay enabled in my HSA account, the hospital got the payment. While talking to the insurance rep, he told me that thay received a claim for u/s with some sort of advanced experimental procedure code (648.93) which is not covered my the insurance. After talking to the doc's office, they said that she dnt put any code at all, so it must be the hospital where i actually had the u/s done. so now m trying to battle between the hospital and the insurance company to get my claim processed rightfully and get the chares applied towards my decductible.........

Please let me know, if you have some information that might be of some help to me.

Thanks

[Anonymous]

I would contact someone in the billing department at your doctor's office and discuss it with them to see if they can help. If not, you will have to go to the hospital's billing center which, in my experience, can be ten times harder than dealing with a doctor! I know when I got my u/s the tech asked if I had any spotting or nausea. I answered "no, not in a while" to both questions and then she said "Okay, well let's list that you have had nausea so your insurance will cover this." If your doctor thought it was medically necessary for you to have the ultrasound, they should have billed it under a covered code - so hopefully they can help. Once they agree to change the diagnostic code they just need to resubmit the claim to your insurance.

[Anonymous]

Thanks for the response. I just found out the same thing happened with a friend. same hospital, same doctor and same mistake. it took him over an year to get things right.

I guess they just want to add an extra headache in the life...as if it already isnt too complicated.

[Anonymous]

OP here - doctor's office has been great - very understanding! The billing person resubmitted the claim to insurance and she said it would take about a week to clear. So... we'll see what happens!