Plan N Question

Jul 10, 2019

  1. Travis Price
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  2. hockeyday
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  3. Travis Price
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    Which I gave you the Cardiac Rehab codes. They do not fall within the OV codes.

    I mean, not to be harsh, but this conversation has become repetitive. Every piece of information you give points in the exact opposite direction.

    It's okay to be incorrect. It's how we learn.
     
  4. hockeyday
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    So you think a doctor is performing cardiac rehab, not ever close, Probley a person with a master degree in exercise science, not even close to a doctor
     
  5. Chazm
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    I’ve had clients ask me about PT and they never had to pay a copay. It’s not supposed to be coded as an office visit. But Vic’s problem is, this facility is going to code it as an office visit and will owe the copay.

    Now, if he calls the insurance company and they said it should not be coded that way, I would inform the client that it shouldn’t be coded that way but his Dr. refuses to code it the correct way.
     
    Chazm, Jul 10, 2019
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  6. Travis Price
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    Except CMS, which you pointed out, gives the codes that should be used. I get it, you didn't nerd out and look up PT and Cardiac Rehab codes.

    I did. In both instances, the codes aren't considered OVs for Plan N. Can weird stuff happen? Totally. Is possible that Cardiac Rehab is wrong? Totally.
     
  7. vic120
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    I am going to give him these codes, If they refuse to apply the correct codes I will contact Cigna afterwards

    Thank you very much
     
    vic120, Jul 10, 2019
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  8. hockeyday
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    He is not going to a doctor, it cardiac rehab, pt, ot, speech therapy, if the bill using doctor office codes it is fraud, call medicare and turn them in..
     
  9. jbage007
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    Is the $20 copay standard, or is it variable UP TO $20?

    Can a doc charge a copay of $5? or $7? or anything else they want, up to $20?

    Anyone know?

    Plan N is about to skyrocket!
     
  10. vic120
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    its the 20% up to $20 as max pay, I do have some clients that say their doc hasn't even charged that However that is not the norm
     
    vic120, Jul 10, 2019
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