Gorospe patients...billing question...

Yesterday I received a bill from Cindy Lamb for what looks to be surgical services in the amount of $1950.00 that was adjusted down to $500.00

I looked on my Aetna website and the claim has been denied. I called Aetna and they said that she billed it at Assistant Surgeon but that they cannot pay her as that since she is a non physician.

$500  compared to $1950 is great. However, I have met my deductible for the year so if this was billed correctly I would not be responsible for any of it. I am not sure how to handle this and wondered if any of you have encountered this same problem??


Thanks,

Lorna
 

I had some similar issues with my facility.  Sometimes they just need to change the coding for her services and that would correct it.  I would call the department that handles the billing for her.

I don't remember having any services performed by her.  Wonder if she was a assistant to the anesthesiologist?  If that was the case, then it was certainly billed wrong.  I would call and find out what she is, a physician or what?  You certainly should not be paying for someone that is not part of the surgery or has proper credencials.

I have never even heard of that name so sorry I cannot help you on this one.

Apparently Cindy Lamb/Taylor is a "Certified Surgical Technician". She bills the insurance as an Assitant Surgeon and AETNA says they cannot pay her as that since she is a non-physician and that she should bill under the surgeon. Whoever handles her billing says that she cannot do that since she is a private individual and does not work through the surgeon. OMG...what a messs. Even though she is only billing me $500 instead of the $1950 she would bill the insurance I am furious that this is even an issue. I have met my deductibles for the year and had not planned for any more substantial doctor bills. Apparently her office has 180 days to appeal the denial so hopefully they can work it out amongst themselves.

**fingers crossed**

OMG..what a mess. I wondered who she was too when I got my claims....it took a while for my insurance to pay, but they did..hmmm. I pray that everything works out girlie.

LaDetra   

I got the  the same bill also. Let me know what you find out.  I thought Aetna didn't pay more becase she was out of network.   I did even question it?  I am  gald you called on it or I would never had known.