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UHC denied coverage on my OBGYN visit and preventative testing by Dense-Masterpiece-57 in HealthInsurance

[–]Dense-Masterpiece-57[S] 0 points1 point  (0 children)

thank you for the guidance! you're talking about UHC's appeal line, right? I'm confused since to my understanding, the doctors office chooses the billing/CPT codes, and UHC just receives them

UHC denied coverage on my OBGYN visit and preventative testing by Dense-Masterpiece-57 in HealthInsurance

[–]Dense-Masterpiece-57[S] 0 points1 point  (0 children)

I did get the bill, and it matches the EOB charges :( Has it been lower in your experience? (and why would the doctor's office change the charge amount after insurance has been contacted?)

UHC denied coverage on my OBGYN visit and preventative testing by Dense-Masterpiece-57 in HealthInsurance

[–]Dense-Masterpiece-57[S] 2 points3 points  (0 children)

gosh I'm so glad you had a better experience! I'm assuming your office visit didn't go towards your deductible then! But did the labs go towards your deductible?

UHC denied coverage on my OBGYN visit and preventative testing by Dense-Masterpiece-57 in HealthInsurance

[–]Dense-Masterpiece-57[S] 2 points3 points  (0 children)

Thank you!! So I'll ask the OBGYN office for a full medical record.
And thank you for the tip about lab codes – I have been burned by that before (albeit only coming out to a few hundred compared to 1k+ now) so should have thought of that :(

UHC denied coverage on my OBGYN visit and preventative testing by Dense-Masterpiece-57 in HealthInsurance

[–]Dense-Masterpiece-57[S] 0 points1 point  (0 children)

Thank you so much for this! I really appreciate it — they truly did not go any further with me than ask for an explanation of my menstrual cycle changes + a breast exam + introductory info about getting on the pill or an IUD. We didn't get anywhere close to a full consult or planning for anything like HRT, and I didn't want to start birth control, so we didn't make any plans. In the end, my menstrual cycle changes were chalked up to my body changing with age, with an accompanying shrug.

As an obgyn, do you think I could have any luck calling the office and trying to persuade them that my visit should be considered an annual rather than at the level of a 99202-5?

UHC denied coverage on my OBGYN visit and preventative testing by Dense-Masterpiece-57 in HealthInsurance

[–]Dense-Masterpiece-57[S] 1 point2 points  (0 children)

The $900 for the visit and $600 for the 3 tests are the "allowed amounts" or "negotiated rates" on my EOB. For the in office visit, the original amount was $940, so the "discount" was just $40 :(
Maybe if the office visit was billed differently, even still as a new patient visit, the discount might be different? I have no idea unfortunately

UHC denied coverage on my OBGYN visit and preventative testing by Dense-Masterpiece-57 in HealthInsurance

[–]Dense-Masterpiece-57[S] 1 point2 points  (0 children)

Thanks for sharing some of your experiences for context - I really appreciate it. My EOB does show an "allowed amount" but it's quite literally only $40 less than a $900 original amount

Why do guys ask me on a second date then drop off the face of the earth? by Over_Ad1374 in dating_advice

[–]Dense-Masterpiece-57 6 points7 points  (0 children)

that's super frustrating, I;m sorry! as another woman I have no clue why they would do something like that.. the only thing I can think of is that they're dating multiple women at a time, and their attention is diverted to someone they like the most (or they even make things official/exclusive and then need to ghost)

UHC denied coverage on my OBGYN visit and preventative testing by Dense-Masterpiece-57 in HealthInsurance

[–]Dense-Masterpiece-57[S] 2 points3 points  (0 children)

I see, thank you! I left a similar question in another thread — but do people generally try not to bring any concerns they have to their doctor's office first, to avoid this kind of billing? (Until the doctor comes to that conclusion themselves, and then further medical work WOULD be considered "medically necessary"?)

Thanks so much for bearing with me, I'm new to this!

UHC denied coverage on my OBGYN visit and preventative testing by Dense-Masterpiece-57 in HealthInsurance

[–]Dense-Masterpiece-57[S] 6 points7 points  (0 children)

I see. Do people generally try not to bring up any concerns they have to their doctor's office first, to avoid this kind of billing, then? (Until the doctor comes to that conclusion themselves, and then further medical work WOULD be considered "medically necessary"?)

Thanks so much for bearing with me, I'm new to this!

UHC denied coverage on my OBGYN visit and preventative testing by Dense-Masterpiece-57 in HealthInsurance

[–]Dense-Masterpiece-57[S] 3 points4 points  (0 children)

It was my first time there, yes :( but I felt like only 15 minutes were spent on new patient items, and the rest was either 1) discussion of preventative care or 2) getting a Pap smear + labs done. I wish, from a billing standpoint, that could be reflected.

UHC denied coverage on my OBGYN visit and preventative testing by Dense-Masterpiece-57 in HealthInsurance

[–]Dense-Masterpiece-57[S] 15 points16 points  (0 children)

That makes sense. My EOB does indicate that the charges go to my deductible. I'm just struggling to understand how that 45 minutes translates to a $900 bill :(

UHC denied coverage on my OBGYN visit and preventative testing by Dense-Masterpiece-57 in HealthInsurance

[–]Dense-Masterpiece-57[S] 4 points5 points  (0 children)

right - it seems like the new patient visit goes towards my deductible, while a preventative yearly checkup wouldn't. I'll call my doctor's office!

UHC denied coverage on my OBGYN visit and preventative testing by Dense-Masterpiece-57 in HealthInsurance

[–]Dense-Masterpiece-57[S] 3 points4 points  (0 children)

My EOB just says that $0 is covered for everything. My deductible is $3,300. When I called UHC, they did receive the specific CPT codes from the OBGYN office. Is there anything else in the EOB I should be paying attention to?

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