So frustrated with surgeon's office...any thoughts?

Please forgive me, possible long post.  I am really getting so frustrated with my surgeon's office and their "coder".

Oct 2012 : presurg labs drawn...  some denied by Medicare and my supplement.  Did not find out until after lab tried resubmitting it 5 x and then called and sent me a bill.  We did not want our credit dinged so we paid the $450 bill.  Called surgeon's office and they said to send them the info and they would "resend" it to Medicare. Which I did and which they did but then I just received the refusal from Medicare because it was "too late."  Grr

Jan 2013: 2 month labs. Medicare summary and I see that  Vit D and Hg1Ac denied by Medicare.  Many calls etc to Medicare and find out it is a coding error.  I fill out appeal form,  fax to surgeon's office and they assure me they will "recode" it.  Still awaiting info on that.  Grr.

May 21: Went in for 6 month labs (minus vit d and hg1ac at surgeon's office suggestion since Medicare has not been paying for this but I think I need these?) and the lab has me sign a form saying that the cbc with diff, iron and ferritin levels will not be covered by Medicare because my condition does not indicate these labs are needed.  So I asked the lab girl if this was a coding error and she said probably but when it is denied to just send it to my surgeon's office so they can resubmit it.   HUH????

So am I out of line here?  Am I going crazy?  Shouldn't the correct codes be in place in the first place?  I specifically asked the surgeon's office to send me a new lab request with the proper codes so this did not happen again with the denials.  Wow... glad I was prepared, grrr. 

I am preparing a letter to the CEO of the Hospital and bariatric center since multiple phone calls to the financial patient counselors etc yielded no help.  They keep referring me back to the surgeons office and the same coder.  GrRRR.  

It is sad cuz I love my surgeon and his staff but if they cannot code it properly my love only goes so far, you know what I mean??? 

Should I go to another center?  Would another bariatric surgeon even consider seeing me?  I mean the bariatric centers solution is to just eliminate the labs that Medicare won't pay for???? I thought that the malabsorption aspect for the first 6 months to a year would/should be covered?  Am I just worried for nothing? 

We are facing another 800 dollars worth of labs to pay for which should not be if it were coded correctly.  I am beyond frustrated.  I will go for the 6 month check up but if anyone has any other suggestions, I would love to  hear them.

Is anyone else dealing with this sort of problem?  

Thanks

I cannot imagine how frustrating this is. Do not give up. Perhaps the office manager at your surgeon's can help.
I had to rip the 'insurance specialist' at my surgeon's office a new set of nostrils because she kept screwing up. I did finally go to the office manager.
What about finding out from Medicare what tests are covered with what diagnoses? I am positive this moronic coder is not supplying the right diagnosis codes with the requests, which is just purely sloppy and lazy.
Keep us updated and good luck.

Thanks, Rosy... oh trust me I am a bulldog when it comes to this stuff, LOL.

I start out very nice and understanding but as I build up steam, look out, LOL>  office manager... oh that is a thought.  Probably she is the coder too, LOL.  

I will let you all know how my little drama works out.  Feel so lucky to have had such a great surgeon, surgery and such success but honestly!

How long should we be having labs drawn?  Which ones should we be getting?  I should ask Kelly, or Lori or some of the vets cuz they could tell me. 

My surgeon's protocol is at six months then yearly. Go to the ASMBS website for a complete list of recommended labs. And go get 'em on the coding LLM!

Oh that is right... thanks, Rosy.. what is the coding LLM?  Is that on the ASMBS site as well?  

Abbreviation of hour screen name

Duh, oh yeah... sorry... thanks, blushing at my silliness.. haha

Let me say two things.

DITTO!

and
 

Bless your heart! I would be having to take blood pressure meds over this. Egad!

We malabsorb micronutients forever and yes, Medicare should cover them.  They have covered all my labs, every six months, since my surgery.  Actually, it was every three months the first year, but every six months since then. 

If you really like your surgeon, I would suggest speaking with him personally before looking for a new surgeon.  Tell him you really like him and feel he's provided good care but that you are fed up with his staff and their inability/refusal to code things correctly. Ask him if he can take care of that for you.  If he can't, then I'd start asking your PCP to order your labs.  Just take the PCP a list of what you need ordered.

Excellent suggestion, Kelly!  I will do this.  Thanks again for the great advice.