Insurance claims can be tricky, frustrating, and time-consuming, and are even more complicated if you aren't a specialist on medical billing codes and practices. Fortunately, there are many clubfoot parents who've been through all types of fights and scenarios with their insurance providers. Here are some tips on having your claim approved and receiving the proper benefit amounts:
STAY ORGANIZED - This cannot be stressed enough crampon mercurial! Generate a folder or envelope to keep all invoices/receipts in. Obtain a dollar-store little notepad to keep note of dates, times, and names of people you consult with and what you talk about.
Do as much through e-mail or any other forms of written communication as possible. This helps with documenting who said what so when. Through an answer on paper is the greatest way to get the correct answer because insurance providers don't wish to released anything on paper they cannot honor later. They won't win in a suit.
Take a look at invoices for accuracy. Make sure the proper medical codes are used for both diagnosis and also the treatment or medical device provided. If something doesn't look right, call the provider first. They will explain what the charge is for and you may distinguish whether it's legitimate. The normal diagnosis code for clubfoot (congenital) - talipes equinovarus is 754.51 (source: ICD-9-CM). If you notice another diagnosis code, double-check using the provider because mistakes can occur. You can find this code yet others in the standard billing codes indexed by the ICD. Should you order the Ponseti bar and Mitchell shoes from the manufacturer, MD Ortopaedics, there's a reference online listing each of their products and the respective billing codes. You can use this to check on with your insurance carrier before ordering.
Know your benefits. Take a look at insurance provider's benefits packet for your specific plan. Specifically, you will want to locate a clause that talks about the exclusion of foot deformities or problems. This generally applies to things like this problem, bunions, etc. and never clubfoot (because clubfoot is a congenital birth defect, no acquired foot disorder). For this reason the diagnosis code on everything for your clubfoot treatment must be correct scarpette da calcio. The insurance company won't know it is necessary for treatment of a birth defect if it's not coded correctly. Speak with your insurance provider about this in advance to determine what's deemed necessary beneath your plan's benefits. For instance, my insurance provider still considers a pair of boots and bar a "durable medical device," so it has specific benefits that are not the same as my prescription medication benefits. Most importantly, realize that each plan is completely independent and various from another person's and the plans also differ under the same company's umbrella. BlueCross BlueShield, for example, has THOUSANDS of plans scarpe calcio nike with THOUSANDS of variations on benefits. Just because another person has BCBS insurance and everything was covered 100% with no out of pocket expense does not mean your BCBS plan is going to do exactly the same.