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  1. #1
    Join Date
    Jan 2007
    Posts
    1

    Default Must you pay for a mistake?

    My doctor had me schedule an MRI procedure. I called my insurance company and pre-authorized for an MRI procedure at a certain clinic. One month later I get a denial message from the insurance company saying that it was an MRA procedure. My results from the doctor list it as an MRI. Could I be forced to pay for a terminology mixup at the clinic? The clinic seems to think that I'm liable for their mistake.

  2. #2
    Join Date
    Apr 2006
    Location
    not sure
    Posts
    526

    Default Re: Must you pay for a mistake?

    Why hasn't the clinic re-submitted a request for payment from the insurer with the correct coding/diagnosis?

  3. #3
    Join Date
    Oct 2006
    Location
    supratentorial region
    Posts
    818

    Default Re: Must you pay for a mistake?

    Quote Quoting kellamd
    View Post
    My doctor had me schedule an MRI procedure. I called my insurance company and pre-authorized for an MRI procedure at a certain clinic. One month later I get a denial message from the insurance company saying that it was an MRA procedure. My results from the doctor list it as an MRI. Could I be forced to pay for a terminology mixup at the clinic? The clinic seems to think that I'm liable for their mistake.
    It's probably a clerical error. Chances are they already received the same EOB (explanation of benefits) or denial notice you have and corrected the coding error. For your own piece of mind, call the facility and speak with the office or billing manager to confirm it has been corrected and resubmitted. Good luck

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