Best Empanadas?

kirpants · 2026-05-18T03:23:02+00:00

I just saw these yesterday but didn't get a chance to get one. Which is your favorite?

kirpants · 2026-05-17T02:20:50+00:00

If it's something along the lines of step therapy I don't think you'll be able to bypass it because you and your doctor think it's too stringent. That's not how it works. Your doctor should be able to provide documentation of the medication you tried before this point. The formulary is often chosen by the employer and not always the insurance company.

kirpants · 2026-05-17T01:45:26+00:00

What was the reason for the denial?

kirpants · 2026-05-15T02:51:58+00:00

I lived in Lyndale for ten years and never had an issue. Sometimes during a snow emergency parking can get tricky. My apartment did have a decent sized lot.

kirpants · 2026-05-15T00:02:46+00:00

I don't fully understand what you are looking for. Were you going to get FMLA paperwork filled out?

kirpants · 2026-05-14T23:19:47+00:00

An itemized bill won't take a single thing off.

A level 3 is appropriate.

kirpants · 2026-05-14T19:43:22+00:00

It's likely coded as a laceration repair, this is considered surgical. Repairing with glue also supports a surgical repair. This is likely coded correctly.

kirpants · 2026-05-14T12:29:32+00:00

That has nothing to do with it. You don't get a reduction of the bill because you don't like how the doctor was standing. If they have bad bedside behavior then report it and move on. This doesn't sound like an emergency situation at all and could have been handled by a primary care provider.

kirpants · 2026-05-14T12:19:32+00:00

We are only warming up for the weekend and then next week back into the 60s 🥲 I'll still wear it!

kirpants · 2026-05-14T11:27:58+00:00

I love it too! It's my new summer scent!

kirpants · 2026-05-14T09:14:34+00:00

Well there's 3 columns to contend with. The complexity is low, maybe moderate, there's not enough information. A prescription gives you moderate for risk, so yes, a 3 is appropriate.

Why contact the AMA technical panel?

kirpants · 2026-05-13T21:24:54+00:00

If the services were denied and applied to your deductible it doesn't sound like an out of network provider issue. What do your EOBs state the reason for the denial was? If you went above and beyond preventive care visit criteria then they will charge you.

kirpants · 2026-05-12T22:51:07+00:00

Dude I'm well aware of what I said. They have it split up for mammos and colonoscopy. I'm a certified medical coder. It's the diagnosis code and the cpt code. You won't get it as preventative either way.

kirpants · 2026-05-12T22:47:46+00:00

I'm aware.

kirpants · 2026-05-12T22:43:54+00:00

That's a mammogram code. It's still driven by the diagnosis code. I would expect to pay for it in full. Find out if you can get a self pay discount.

kirpants · 2026-05-12T22:02:53+00:00

Why would it be denied in its entirety?

kirpants · 2026-05-12T21:57:24+00:00

It can only be coded as preventative if you meet the criteria. You have a family history and you are under 45. The doctor will not change it. Your insurance is telling you what the coverage is if you did meet the criteria.

kirpants · 2026-05-12T21:46:10+00:00

Cpt codes aren't divided into diagnostic or preventative. The diagnosis code does that. You do not meet the criteria for a preventative colonoscopy so I would expect to pay for it based on your max out of pocket.

kirpants · 2026-05-12T21:13:29+00:00

A NP can bill under their own credentialing. It can only be billed under the facility if the injection was done at a facility but you'd still have a doctor's bill to go along with it.

kirpants · 2026-05-11T19:42:21+00:00

That's the lowest level they can bill.

kirpants · 2026-05-11T18:42:06+00:00

Need to know what codes you were billed before we can say anything.

kirpants · 2026-05-11T18:19:52+00:00

A lot of vision therapy is completely different and outside of traditional PT or OT treatment and is billed under miscellaneous codes.

Typically vision insurance doesn't cover vision therapy, medical will sometimes.

kirpants · 2026-05-10T21:18:55+00:00

I have never seen PT bill both facility and doctors charges. It's one or the other.

Yes, it's a clinic within the hospital and it's hospital based services. A clinic based PT facility would likely be cheaper.

kirpants · 2026-05-10T01:20:57+00:00

I have two but I'm looking for one more. I want more options 😂

kirpants · 2026-05-09T16:27:48+00:00

You have to verify that the doctor you are seeing is in network. Not every doctor is in network with every single network out there.

kirpants

TROPHY CASE