Anyone understand this claim?
I can’t access the EOB. it won’t download.
Basically my mom went for a pre-approved colonoscopy. No problem. Claim denied later, because her Medicare had kicked in 7 days prior. She got an explanation of benefits from Molina saying her portion was ZERO, so she put the paperwork away and went along her business.
Bill comes at some point later, and surprise… It’s big. Medicare denies, because Dr office didn’t bill quick enough? Molina doesn’t seem to know WHAT they’re doing, because they’ve paid, denied and pended it. (no. It’s not paid.)
Does anyone know what the codes are after the numbers for the claim ID mean? (WA state if it matters)
The Dr has resent the bill to Medicare to ask them to reconsider (according to her Medicare account, they haven’t gotten it, 3 months later) and this is what shows on the molina account.
She filed for charity care for the bill, but of course they don’t want to pay if the insurance will pay.
Anyone with any experience with something like this? Anyone have ideas? Anyone have… Anything? 🤣 I’m so lost with this. Thank you.
