Inaccurate coding. Provider’s office won’t budge. Claim denied.
This situation is so stupid that I can’t believe it’s the issue it is. I took my 12 year old to a new dermatologist (highly recommended) because I thought he had a wart on the bottom of his foot. We met with a NP. She took a look, scraped off a little dead skin to confirm, and said “Nope. It’s just a corn. No treatment needed.” Great! We paid our co-pay for the visit and went on our merry way.
Shortly after I received a denial from BCBS:
“BENEFITS ARE AVAILABLE FOR THE CUTTING, TRIMMING OR REMOVAL OF CORNS, CALLUSES OR THE FREE EDGE OF NAILS ONLY WHEN PERFORMED AS ROUTINE FOOT CARE FOR A PATIENT WITH A METABOLIC OR PERIPHERAL VASCULAR DISEASE, SUCH AS DIABETES. THE CARE YOU RECEIVED DOES NOT MEET THESE CRITERIA. THEREFORE, YOU ARE RESPONSIBLE FOR THESE CHARGES….”
I didn’t seek care for a corn nor did I receive care for one. I called the provider office and spoke to billing and then a supervisor in billing. They said it was diagnosed as a corn, so that’s what was submitted. Refused to budge. I called BCBS and they said they can only go on what it was coded as, and also refuse to budge.
I reached out via the providers portal. I can’t message the NP we saw directly, only her “team” head by an Md so I did that. No response after over a week.
So at the moment I’m left to “foot” the whole bill (… I’ll see myself out 🤭). Is there anything else I can do?