Below are four things to know about the coding error.
1. Last May, a female patient underwent a mammogram at a health clinic that is part of the same network at St. Mark’s Hospital in Salt Lake City. She received normal results. The mammogram, considered a preventive service, was covered in full by the patient’s insurance plan.
2. The clinic coded the procedure as diagnostic instead of routine, as if the mammogram had uncovered a problem with the patient’s health. This means the patient’s insurance plan would not cover the expenses for the mammogram. The patient received a bill for $381.87.
3. St. Mark’s Hospital handles the coding and billing functions for the clinic where the patient underwent the mammogram. The patient said she had contacted the hospital and insurance company every month since last May to try and resolve the coding error, to no avail.
4. St. Mark’s Hospital spokesperson Danielle Wilcox said the story exposed a glitch in the way billing errors are resolved. “We are absolutely learning from this and trying to prevent it from happening again in the future,” Ms. Wilcox told KUTV.
More articles on revenue cycle management:
Geisinger patient refund policy spurs at least 1 health system to consider the idea
US payments on prescription drugs rose 12.2% in 2015: 7 things to know
Survey finds retirement savings stunted by healthcare costs
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
