Hi Dan,
I agree that insurance never pays charge master prices. When it comes to individuals hospitals charge full list price. As an example I requested a blood test, doctor agreed that I should have it. I went to hospital and was told that I would have to pay $233 up front to have it done. I was told Medicare would not pay on the code the doctor gave. I asked what is the proper code. They refused to tell. I went back to the doctor and they tried a different code. It went through and Medicare paid $18.32 for the test. I had other instances where I was improperly billed and it was always at full list price.
Has anyone else have SCT claim denied by Medicare?
Ray
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