Plateau Hospital: Have you been in the Emergency Room?

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Medical Victim

Beckley, WV

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#23
Feb 13, 2013
 
dittybugdaisy wrote:
CPT Code 99283
Caledonia Financial Services, LLC
Optimal Billing Solutions, LLC
I don't see a CHRG code on here.
Service description says Emergency Dept Visit Amount 390.00
So what have you got in mind?
The charge code (CHRG CODE) is on your bill from Plateau Medical Center. It's in the 2nd column, just to the right of the date which is in the first column. I'm assuming you got an itemized bill, didn't you? Or did you just get a statement? The statement should have come in the mail after you got the itemized bill.

CPT codes, 99281, 99282, 99283, 99284 and 99285 are the common emergency room codes and they are used two ways:(1) The hospital assigns one of these five codes to indicate the level of severity of your emergency room case and (2) the doctor also uses the same codes to indicate the level of severity and complexity of your case. The fifth number of these CPT codes indicate the level of severity and complexity. So, 99281 is for simpler emergencies and 99285 is for the most severe and complex. The prices increase with each step up the ladder.

You said in post #18 that Plateau billed you $286.29 for the use of the emergency room. You should look at your Plateau bill to see what CPT code they used to generate a charge of $286.29 Did both the hospital and the doctor use the same code?

If Plateau billed you for a 99281 and Dr Clinton billed you for a 99283... well, maybe you should be asking questions. The practice of using more expensive codes is called up-coding.

Here is more information about these CPT codes:
http://www.bluecrossmn.com/bc/wcs/groups/bcbs... @mbc_bluecrossmn/documents/pub lic/post71a_149100.pdf

Medical Victim

Beckley, WV

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#24
Feb 13, 2013
 
Here's that link again:

http://www.bluecrossmn.com/bc/wcs/groups/bcbs... @mbc_bluecrossmn/documents/pub lic/post71a_149100.pdf

If it doesn't work, just google for information on these codes yourself.
dittybugdaisy

Oak Hill, WV

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#25
Feb 14, 2013
 
I looked at the only bill we have for PMC and there isn't a code on it at all. It just says emergency room services. We did get one that day on the way out but I didn't even look at it. We were told $190 and I was ok with that because I knew it would be around that much. Since then they've sent one bill and it has a statement on there about how they hope they've met our needs and how happy they are to serve you. Then it goes on to say there may be programs to help with health care if we qualify and so on. No code on it and nothing itemized either. Just a very vague statement of "emergency room services"
dittybugdaisy

Oak Hill, WV

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#26
Feb 14, 2013
 
Medical Victim wrote:
Here's that link again:
http://www.bluecrossmn.com/bc/wcs/groups/bcbs... @mbc_bluecrossmn/documents/pub lic/post71a_149100.pdf
If it doesn't work, just google for information on these codes yourself.
By the way thank you for your time. It's interesting how they try and do!! I know of agencies that fraudulently bill Medicaid also.

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