Employee Benefit Cards -copay per doctor visit

Recently, I had a patient that contacted me, to inform me that her Employee Benefit Card was frozen since June. She was so distraught that she was not able to go to the doctor appointments because she was told we overcharged her for a visit.

What?! One thing that I value the most is honesty. “Fraud”- this word that does not sit well with me. I cannot admit or deny that I have seen any medical billing fraud, but it is something that I do not kid about!

Of course, I calmed her down and explained her that there is a perfectly good explanation why we charged her that specific amount for the visit instead of her usual copay. I assured her that I will get to the bottom of this and find out what is going on, and would contact her once I finish my research.

Anyway, after doing some research, I found out that we charged her for 2 DOS’s (dates of service), since she did not pay for her last visit. She used her card on that specific dos to pay for two.


However, what she nor I were aware of is that she cannot charge more than her copay per each visit.

Luckily, I was able to help this patient by sending an explanation along with the EOB, from her insurance, to the Employee Benefit Card Services. She was able to lift her suspension from the card and use it again.

The moral of this story: as a rule of thumb, use your Benny Card to pay only your copay and no more than that amount. Otherwise, you will be in the same situation as this patient and would have to go through the same ordeal.

As for Provider office front staff: make sure to charge only the copay for the given visit. Hint: if you have more than 2 people in the front desk it is extremely helpful to make a list of the patients that do have the Benny card, this way everybody in the office is on the same page!

ICD-10 is coming, are you ready?

Ok, so don’t panic! Starting October 1, 2015 ICD-10 is taking over. If you are already working as medical coder or biller in a medical office, you already know that every one is preparing for that very important transition!

Considering that there are going to be 68,000 ICD-10-CM codes and 87,000 ICD-10-PCS codes compared to 14,000 ICD-9-CM codes and 4,000 ICD-9-PCS codes available, will make you feel extremely overwhelmed!

ICD-10 Reference Guide
ICD-10 Reference Guide

Well don’t fret. You can make your life much more easier by purchasing easy and quick ICD-10 reference guide, by specialty. (You may purchase for $49.95 (member price) or $59.95 for non-members)

unnamedYou may also download ICD-10 Reference Guides for the desk in your practice (by specialty) *Don’t really know the price for this: they have a form that you would fill out with the doctor and your information.

Did you find any other great and easier ICD-10 recourses? Please feel free to share your thoughts, comments here.