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Medicare denied a doctor's visit claim 99203 because payment was included in another service the same day. I keep getting bills for it. Medicare said I could not be billed separately for it and did not have to pay it.

Is this on your Medicare Statement? If so, call the billing office and tell them that you have proof from Medicare that you don't owe this charge.

If the doctor office feels they are owed this, because it is for the visit, THEY not you need to contact Medicare and find out how to code it to get paid. Sometimes its a coding error and fault of the person that puts in the claim. Do not get rid of that Statement unless you are sure the charge has been removed.

If you continue to get billed once you have proved u do not have to pay, call Medicare and ask if they can call the doctor.
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Reply to JoAnn29
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MACinCT Jul 14, 2024
I used to get extra bills for my mom and my son when he was younger. You need to contact the billing department and tell them that insurance is not paying and why. Insurance informed you that you do not have to pay. You can inform the biller that you will file a compaint to the insurance company if they want to continue billing. Those complaints about a provider might penalize the provider which is the intent of your statement. Some billing departents are better than others. They might have to send a different code to insurance to get reimbursement.
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If Medicare says you can't be billed, then you can't be billed. It's been a while since I've seen a Medicare explanation of benefits form, but I think they always include a phone number to call if you suspect fraud. Maybe give that number a call and let them know what's going on.
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Reply to LyndeeNew
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Lyndee, it could be just an error on the Doctor's office's part . They also get a statement concerning what they get paid and don't get paid. Its a matter of the billing clerk to review Medicare's payment and either writing off the charge or recoding so they get paid. Medicare will tell you, they are never wrong.
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LyndeeNew Jul 13, 2024
Yes, it could be just an error but having lived on this earth for more than several decades, I have found that it is best to take your issue to the person or entity with the most power. If Medicare calls the doctor's office, they're going to listen. I have found doctor's office billing people, who may not even work directly for the doctor but for an outside billing service, to be not that responsive to billing disputes. They say they're going to take care of it and then the next thing you know, you get the bill in the mail again. You call back, talk to someone different and they have no idea what you are talking about. Just go to Medicare and let them take care of it, IMHO.
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