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US Insurance Codes

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Hi all,

 

We seem to get this question coming up time and time again. I'm sure it

must be difficult to use the group's archive function. I've tried to

use it myself with little success. I therefore suggest, before people

outside the US go nuts with this constant qustion, that someone

knowledgeable to write up the codes into a Word document and upload it

to the files section of the group. Actually, i may even publish it in a

future issues of CMT, so everyone can have free access to it.

 

Wouldn't that be a lot easier.

 

Attilio

www.chinesemedicinetimes.com

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On Tuesday 06 February 2007 11:57 am, wrote:

 

> We seem to get this question coming up time and time again. I'm sure it

> must be difficult to use the group's archive function. I've tried to

> use it myself with little success. I therefore suggest, before people

> outside the US go nuts with this constant qustion,

 

Hi Attilio!

 

If only it were something that could be settled. Unfortunately, the insurance

companies keep changing the codes, both to force claim submitters to

/buy the book and also to provide a continuing basis to get out of

paying claims. There is no ethics when there is that much money changing

hands.

 

I have even heard of people using the new code and having that denied. Then

resubmit with the old code and that be denied as well. The insurance

companies want you to get tired and give up. Then they get to keep the money

for themselves. There is even a thirty day limit to submit the bill, but no

limit on how long it takes them to pay!

 

The only thing wrong with the old codes is that people got to know how to use

them, then the insurance had to pay. Can't have that!

--

Regards,

 

Pete

http://www.pete-theisen.com/

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Why am i not surprised?

 

Ok, i've got another solution. Why doesn't someone write a column on

the insurance codes for my online journal; Times.

Every two months the person would write about the new codes and tips

n tricks on getting your money out of the insurance companies.

 

How's that sounds? Any takers?

 

Attilio

www.chinesemedicinetimes.com

 

 

Chinese Medicine , Pete Theisen

<petetheisen wrote:

>

> On Tuesday 06 February 2007 11:57 am, wrote:

>

> > We seem to get this question coming up time and time again. I'm

sure it

> > must be difficult to use the group's archive function. I've tried

to

> > use it myself with little success. I therefore suggest, before

people

> > outside the US go nuts with this constant qustion,

>

> Hi Attilio!

>

> If only it were something that could be settled. Unfortunately, the

insurance

> companies keep changing the codes, both to force claim submitters

to

> /buy the book and also to provide a continuing basis to

get out of

> paying claims. There is no ethics when there is that much money

changing

> hands.

>

> I have even heard of people using the new code and having that

denied. Then

> resubmit with the old code and that be denied as well. The

insurance

> companies want you to get tired and give up. Then they get to keep

the money

> for themselves. There is even a thirty day limit to submit the

bill, but no

> limit on how long it takes them to pay!

>

> The only thing wrong with the old codes is that people got to know

how to use

> them, then the insurance had to pay. Can't have that!

> --

> Regards,

>

> Pete

> http://www.pete-theisen.com/

>

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Pete,

 

The AMA is the one who owns the cpt codes and not the insurance companies

although

at times it seems that they are one in the same (conflict of interest big time).

 

Denial for acupuncture could be for several reasons and one is that the

provider's state

statutes might not mandate payment. In other words, an LAc might not be the

provider

of choice mandated by legislation to get paid for acupuncture. I know it sounds

weird but

we have had to deal with our lack of identity and under utilization as a result

of being forced

to ask other providers for prescriptions for auto care (PIP) in MN.

 

In many states, insurance companies have a 30 day window, as well, in order to

pay or deny

the claim. Otherwise, by law, you can charge them interest on this. I worked

in the insurance

industry, on behalf of various hospitals, and saw many attempts by insurance

companies to try

to get out of paying legit claims. There were also times when the hospital

messed up and

had to eat the bill.

 

It is issues like this where we need more education and less speculation. Mike

W. Bowser, L Ac

 

 

:

petetheisen: Tue, 6 Feb 2007 12:29:46 -0500Re: US

Insurance Codes

 

 

 

 

On Tuesday 06 February 2007 11:57 am, wrote:> We seem to get

this question coming up time and time again. I'm sure it> must be difficult to

use the group's archive function. I've tried to> use it myself with little

success. I therefore suggest, before people> outside the US go nuts with this

constant qustion,Hi Attilio!If only it were something that could be settled.

Unfortunately, the insurance companies keep changing the codes, both to force

claim submitters to /buy the book and also to provide a continuing

basis to get out of paying claims. There is no ethics when there is that much

money changing hands.I have even heard of people using the new code and having

that denied. Then resubmit with the old code and that be denied as well. The

insurance companies want you to get tired and give up. Then they get to keep the

money for themselves. There is even a thirty day limit to submit the bill, but

no limit on how long it takes them to pay!The only thing wrong with the old

codes is that people got to know how to use them, then the insurance had to pay.

Can't have that!-- Regards,Petehttp://www.pete-theisen.com/

 

 

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On Tuesday 06 February 2007 5:27 pm, mike Bowser wrote:

> Pete,

>

> The AMA is the one who owns the cpt codes

 

Hi Mike!

 

I had heard/read this somewhere but perhaps not so clearly stated, thanks for

that. Curious that the AMA would be writing our billing codes but perhaps I

ought not go there.

 

I have had the thought of suggesting to my state representative that health

insurance companies doing business in our state should be required to pay for

any form of healthcare licensed by the state with no shenanigans. That ought

to get every rep in the house a free meal on the insurance lobby's dime to

vote that down, perhaps a free meal with a young, cute escort for company!

What do you think?

--

Regards,

 

Pete

http://www.pete-theisen.com/

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Like the dinner thing, though doubt it will get far. The ideas you are making

are

part of a larger strategy known as universal coverage and the type we are

advocating in MN is a single payer system. I am glad to hear of other

professional

interest as this is how we can become more involved with needed changes for our

patients and also provide more acupuncture care to needed populations.

I would like mine blond (just kidding).

 

Mike W. Bowser, L Ac

 

________________________________

> Chinese Medicine

> petetheisen

> Tue, 6 Feb 2007 19:56:08 -0500

> Re: US Insurance Codes

>

> On Tuesday 06 February 2007 5:27 pm, mike Bowser wrote:

> > Pete,

> >

> > The AMA is the one who owns the cpt codes

> Hi Mike!

> I had heard/read this somewhere but perhaps not so clearly stated, thanks for

> that. Curious that the AMA would be writing our billing codes but perhaps I

> ought not go there.

> I have had the thought of suggesting to my state representative that health

> insurance companies doing business in our state should be required to pay for

> any form of healthcare licensed by the state with no shenanigans. That ought

> to get every rep in the house a free meal on the insurance lobby's dime to

> vote that down, perhaps a free meal with a young, cute escort for company!

> What do you think?

> --

> Regards,

> Pete

> http://www.pete-theisen.com/

>

 

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On Wednesday 07 February 2007 1:29 pm, mike Bowser wrote:

> Like the dinner thing, though doubt it will get far. The ideas you are

> making are part of a larger strategy known as universal coverage and the

> type we are advocating in MN is a single payer system. I am glad to hear

> of other professional interest as this is how we can become more involved

> with needed changes for our patients and also provide more acupuncture care

> to needed populations. I would like mine blond (just kidding).

 

Hi Mike!

 

I guess I wasn't clear. My comment assumed that the insurance lobby would

oppose the idea of expanding the list of things they have to pay for and

would ply the members of the legislature with food, drink and, uh,

*entertainment* to induce a " no " vote on the issue.

 

That's if they don't just outright bribe them with cash

 

> > On Tuesday 06 February 2007 5:27 pm, mike Bowser wrote:

> > > Pete,

> > >

> > > The AMA is the one who owns the cpt codes

> >

> > Hi Mike!

> > I had heard/read this somewhere but perhaps not so clearly stated, thanks

> > for that. Curious that the AMA would be writing our billing codes but

> > perhaps I ought not go there.

> > I have had the thought of suggesting to my state representative that

> > health insurance companies doing business in our state should be required

> > to pay for any form of healthcare licensed by the state with no

> > shenanigans. That ought to get every rep in the house a free meal on the

> > insurance lobby's dime to vote that down, perhaps a free meal with a

> > young, cute escort for company! What do you think?

--

Regards,

 

Pete

http://www.pete-theisen.com/

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I know what you mean. The CEO pay for 05' was reported for the HMO's

and no wonder why things are the way they are. These guys are making

obsene amounts (multi-millions). That is enough on this as it is not

related closely to OM. Thanks for allowing me to digress. Back to OM !

 

Mike W. Bowser, L Ac

 

________________________________

> Chinese Medicine

> petetheisen

> Thu, 8 Feb 2007 01:02:14 -0500

> Re: US Insurance Codes

>

> On Wednesday 07 February 2007 1:29 pm, mike Bowser wrote:

> > Like the dinner thing, though doubt it will get far. The ideas you are

> > making are part of a larger strategy known as universal coverage and the

> > type we are advocating in MN is a single payer system. I am glad to hear

> > of other professional interest as this is how we can become more involved

> > with needed changes for our patients and also provide more acupuncture care

> > to needed populations. I would like mine blond (just kidding).

> Hi Mike!

> I guess I wasn't clear. My comment assumed that the insurance lobby would

> oppose the idea of expanding the list of things they have to pay for and

> would ply the members of the legislature with food, drink and, uh,

> *entertainment* to induce a " no " vote on the issue.

> That's if they don't just outright bribe them with cash

> > > On Tuesday 06 February 2007 5:27 pm, mike Bowser wrote:

> > > > Pete,

> > > >

> > > > The AMA is the one who owns the cpt codes

> > >

> > > Hi Mike!

> > > I had heard/read this somewhere but perhaps not so clearly stated, thanks

> > > for that. Curious that the AMA would be writing our billing codes but

> > > perhaps I ought not go there.

> > > I have had the thought of suggesting to my state representative that

> > > health insurance companies doing business in our state should be required

> > > to pay for any form of healthcare licensed by the state with no

> > > shenanigans. That ought to get every rep in the house a free meal on the

> > > insurance lobby's dime to vote that down, perhaps a free meal with a

> > > young, cute escort for company! What do you think?

> --

> Regards,

> Pete

> http://www.pete-theisen.com/

>

 

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http://get.live.com/search/overview

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