I let the billing supervisor speak for a moment, and then cut him off using the ammo I had acquired from billing-coders' blogs. "You billed a G0390 for trauma-team activation. But chapters 4 and 25 of the MCPM require there be EMS or outside hospital activation if you are billing a G0390. There was no such activation here. So here is what I need you to do: Remove that $10,000 charge and reissue the bill."
He was silent for a moment. And then he said, " Let me talk to my supervisor."
...To the hospital's immense credit, they sent a refund to our insurance company and reissued the bill without the $10,000 trauma activation. They could have refused. What would my recourse have been? To hire a lawyer? Try to interest my insurer in fighting over a measly $10,000 charge? That is a tiny line item in their book of business.All of us have experienced or know people who have experienced similar nightmares.
A question for any experts who read this blog. Surely there is a business opportunity here, no? "We negotiate your medical bill." It is a huge waste of resources for Mr. David a "co-founder and chief strategy officer of Organovo Inc., a biotech company in California" to spend hours on the phone and more hours on the internet learning about medicare coding procedures. And all his acquired knowledge is now wasted. Surely such a business could operate, like many lawyers, on a contingency fee basis, and take a fraction of money saved.
Yes, as Mr. David points out, this is what insurance companies are supposed to do. But copays are going up, and more people are gong to be paying out of pocket anyway.
Are there businesses like this that I, and Mr. David, simply don't know about?
Update: I knew that were there is demand there must be supply! A correspondent sends me a link to copatient.com, which looks like this: