My insurance coverage for X-rays is very vague. My benefits page shows Radiology/X-ray Facility as no coverage, deductible applies.
But Radiology/x-ray facility- Freestanding Radiology is a co-pay of $150, Radiology/X-Ray Facility-Radiology Imaging Center is also a $150 co-pay.
My son broke his arm and we went to an orthopedic doctor. The orthopedic practice is located on the hospital campus, but is a separate office. Our insurance did not cover the X-ray, I got a bill for $315 and it all went to deductible. I would have preferred the $150 co-pay but it was unclear how it is decided what type of facility you have been to. After speaking to BCBS they seemed to think that Radiology/X-ray Facility refers to a hospital, while the other categories refer to a doctor’s office. We were definitely seen and x-rayed at the orthopedic dr office, the hospital has its own x-ray facilities and we never entered the hospital.
It seems that this doctor group has all its billing handled by the hospital so it appears as if the hospital handled the x-ray. I explained to hospital billing that by billing this way, they are making my insurance think we were seen at the hospital when that is not the case. This should have been billed as Freestanding Radiology, and if we had gone to a different ortho that is not affiliated with the hospital then it wouldn’t be an issue. However they are not able to do anything. Is this correct?
But Radiology/x-ray facility- Freestanding Radiology is a co-pay of $150, Radiology/X-Ray Facility-Radiology Imaging Center is also a $150 co-pay.
My son broke his arm and we went to an orthopedic doctor. The orthopedic practice is located on the hospital campus, but is a separate office. Our insurance did not cover the X-ray, I got a bill for $315 and it all went to deductible. I would have preferred the $150 co-pay but it was unclear how it is decided what type of facility you have been to. After speaking to BCBS they seemed to think that Radiology/X-ray Facility refers to a hospital, while the other categories refer to a doctor’s office. We were definitely seen and x-rayed at the orthopedic dr office, the hospital has its own x-ray facilities and we never entered the hospital.
It seems that this doctor group has all its billing handled by the hospital so it appears as if the hospital handled the x-ray. I explained to hospital billing that by billing this way, they are making my insurance think we were seen at the hospital when that is not the case. This should have been billed as Freestanding Radiology, and if we had gone to a different ortho that is not affiliated with the hospital then it wouldn’t be an issue. However they are not able to do anything. Is this correct?