appledainty
Junior Member
What is the name of your state (only U.S. law)? Florida
I went to the ER after spending an entire day in a lot of pain cause I popped my shoulder out. I popped it back in, but it was still very painful and I wasn't sure if I'd done more damage to it than I thought, so I decided to get it looked at after work at the nearest urgent care/emergency room. I had an xray of my shoulder, and a shot that was given to me by the nurse. The xray, the application of the injection, and the pharmaceuticals in the injection itself were all billed separately from the evaluation fees. The nurse didn't even take my pulse. The doctor is the one who asked me questions an examined me.
I was billed by both the hospital and the doctor for a physical evaluation.
The doctor billed $1527 to my insurance for a 99285. When I researched the code, it said that this is for physician evaluation and management, Level 5.
The hospital billed my insurance $2090 for a 99283 - which is the same thing, physician evaluation and management, but Level 3 instead of Level 5.
Is this fraud? Can they both bill me for the same thing? And why is the hospital charging so much more for a lower level of examination?
I went to the ER after spending an entire day in a lot of pain cause I popped my shoulder out. I popped it back in, but it was still very painful and I wasn't sure if I'd done more damage to it than I thought, so I decided to get it looked at after work at the nearest urgent care/emergency room. I had an xray of my shoulder, and a shot that was given to me by the nurse. The xray, the application of the injection, and the pharmaceuticals in the injection itself were all billed separately from the evaluation fees. The nurse didn't even take my pulse. The doctor is the one who asked me questions an examined me.
I was billed by both the hospital and the doctor for a physical evaluation.
The doctor billed $1527 to my insurance for a 99285. When I researched the code, it said that this is for physician evaluation and management, Level 5.
The hospital billed my insurance $2090 for a 99283 - which is the same thing, physician evaluation and management, but Level 3 instead of Level 5.
Is this fraud? Can they both bill me for the same thing? And why is the hospital charging so much more for a lower level of examination?
