What is the name of your state (only U.S. law)? Ohio
I recently had outpatient surgery on my ankle. Two days after the surgery, I called the drs. office because the bandages were causing my toes to turn purple and they said to come in. I went in and he looked at the incision and re-wrapped my foot....using the same splint I had been given in the hospital and they reused the same ace bandage.
Two days later, I went in for a regular post-op check up that was part of the treatment plan. Again, he unwrapped it, changed the dressing that directly touched the wound and re-wrapped it with the same splint and ace bandage.
Two more follow-up visits were for removal of the sutures he placed during surgery and cleaning up the wound and the last one was just a regular scheduled post-op visit to check on the incision and give me instructions for when to start physical therapy, when it was ok to put weight on it, etc.
According to my insurance company, all post-op visits are covered 100% with no copay.
Last week I rec'd a bill from the dr for $125 for the first two visits for "replacing the splint" (which would take at least 2 hours each visit, I was there maybe 15 minutes each time) and then $30 for each of the four visits for co-pays.
Contacted the insurance office, they said the dr. is not coding the visits as "post op" even though the admit that they are all visits AFTER surgery. They said there is nothing they can do, that it's up to the dr. to code the bills however he wants.
Is this even right? These are POST-OP visits! There would be no other reason I would be visiting this dr other than to follow up on surgery HE performed. And he did not change the splint at all, he reused the same one.
So now I have a huge bill due when I was told before surgery it would be $xxx deductible (which I had already met) and 100% covered for all post op visits. He's obviously doing this to get more money since he knows he's already been paid for my care.
What should I do?