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empire nyship coverage- RMA
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clotheshorse
LIF Adult
Member since 5/12 1293 total posts
Name:
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empire nyship coverage- RMA
I just got my EOB and they are saying my Jan. office visit (sonogram) has been applied to my deductible and I owe the full amt. RMA is a center of excellence and in network. Do you think billing submitted it as OON by mistake?
Does anyone go to RMA that has Empire Insurance nyship that can shed light on this?
My consult was covered which included a sonogram so I'm confused as to what was different.
Of course I get this when I can't call anyone.
Message edited 3/22/2013 7:50:10 PM.
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Posted 3/22/13 7:45 PM  |
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bookworm
Two Little Rosebuds
Member since 8/09 2106 total posts
Name:
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Re: empire nyship coverage- RMA
Tell them to look into it. There shouldn't be a deductible because they are in-network and no copay because the are a center for excellence. I had the same coverage and went to the same office and never paid a dime.
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| Posted 3/23/13 8:49 AM |
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clotheshorse
LIF Adult
Member since 5/12 1293 total posts
Name:
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Re: empire nyship coverage- RMA
Posted by bookworm
Tell them to look into it. There shouldn't be a deductible because they are in-network and no copay because the are a center for excellence. I had the same coverage and went to the same office and never paid a dime.
Hi there! How are you?
I called empire before my iui and they told me you only need prior approval for "big ticket" procedures like IVF and beyond. Not for the sonos, and diagnostic surgery/testing, or ovulation induction because that comes from the regular medical insurance. Maybe it was empire's mistake. Grrrr
You didn't need to call unless for ivf right?
Message edited 3/23/2013 9:06:08 AM.
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| Posted 3/23/13 8:59 AM |
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LIRascal
drama. daily.
Member since 3/11 7287 total posts
Name:
Michelle
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empire nyship coverage- RMA
Just double-check again, especially since it's in network. I say to double-check with internal billing because all of empire's codes have changed, and at my OB something similar happened. When we looked into it, Empire made a mistake and I didn't have to pay for it.... Good Luck
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| Posted 3/24/13 2:49 PM |
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clotheshorse
LIF Adult
Member since 5/12 1293 total posts
Name:
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Re: empire nyship coverage- RMA
Posted by LIRascal
Just double-check again, especially since it's in network. I say to double-check with internal billing because all of empire's codes have changed, and at my OB something similar happened. When we looked into it, Empire made a mistake and I didn't have to pay for it.... Good Luck
That's what I'm thinking happend. In 2012, I had no problems. This is the first claim of 2013 that they must have submitted and probably under a wrong code like you said. Did codes change for 2013 ?
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| Posted 3/24/13 3:25 PM |
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