Hello everyone. I have a claim denial situation and would appreciate any help in this regard. Story below –

Doctor ordered Vit D lab work during annual physical exam since I had a deficiency during my last annual physical. Doctor never told me that I will be charged for this. Doctor and Lab are in network and annual physical is covered 100% under the plan.

Provider billed this to insurance under codes –

E559Diagnosis vitamin d deficiency unspecified Z0000Diagnosis encounter gen adult med exam w/o abnormal find

Insurance partially denied the claim for the Vit D lab but paid the provider for everything. Insurance now tells me that I owe them for the Vit lab work which amounts to several hundred $$.

When I contacted insurance they tell me that provider has billed incorrect procedure and diagnosis codes and they need clinical records / medical history from provider. They are also asking for my permission to contact the provider directly.

Would giving them this permission help me? Please also advise on how to get this fixed generally so that I do not have to pay, as I feel the Vit D lab was ordered as a preventative measure.

submitted by /u/be_a_se
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