If CPT code is invalid and not billable, what do I need to say to medical provider’s office?

Hello,

I posted this last Saturday and today I got to talk to United healthcare today and learned following:

1) Invalid/Not billable code was submitted in a claim that's not covered, which is why it costs more. There were total 3 billing codes in this claim, and one is not considered what UHC says "Invalid and not billable"

2) Interestingly, when I initially reached out to medical provider's office, they told me only one CPT code, meaning that had I known this "invalid/not billable code" in advance, I would have reached out to UHC to ensure coverage is effective.

3) UHC recommends to talk to medical provider's office, implying that re-submitting correct code may cover the procedure, and I have never done this before.

Tomorrow, I will reach out to the office and see what's going on there. Before I reached out, what should I be aware and how do I approach it?

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For my perspective, had I been made aware that there were 3 CPT codes, I would have reached out to UHC and determined if or how much it would have covered, but because they did not inform me correct information, I was forced to make an uninformed decision, which may result in financial burdens (they charged almost 3 grands for this simple procedures and I have already maxed out of pocket, meaning that this service would have been free)

I have written communication records between me and medical provider's office as well, if they can deflate the question here.

What's the best course of an action when reaching out to medical office's provider?

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Thank you so much

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submitted by /u/taintmoun
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