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Old 06-04-2009, 04:39 PM - Thread Starter
 
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We have an individual/family plan that is self funded (options blue). I recently became pregnant again and now some of the EOB's are coming through. Prenatal care is supposed be 100% cover with no deductible. But I'm getting billed for medically necessary ultrasound and labs (due to my previous pregnancy being ectopic).

Did your BCBS plan coverage routine and medically necessary scans and labs?

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Old 06-04-2009, 06:12 PM
 
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I had BCBS for DS's pregnancy and birth. And yes, they did cover routine prenatal stuff 100%. But that was 6 yrs. ago....

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Old 06-05-2009, 01:38 PM
 
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Quote:
Originally Posted by anicholsonmartin View Post
We have an individual/family plan that is self funded (options blue). I recently became pregnant again and now some of the EOB's are coming through. Prenatal care is supposed be 100% cover with no deductible. But I'm getting billed for medically necessary ultrasound and labs (due to my previous pregnancy being ectopic).

Did your BCBS plan coverage routine and medically necessary scans and labs?
i have BCBS and had 100% prenatal coverage. they made an error once or twice. i had to make them correct it. i remember that my 12 week quad screen they tried to deny. they tried to call it genetic counseling or something?

i'd call your hospital and ask them how they "coded" what's being denied. they can recode it and resubmit it. if that doesn't work, call BCBS.
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Old 06-05-2009, 01:39 PM
 
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we use park nicollet, btw. they have made a few billing/coding errors over the years...
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Old 06-06-2009, 12:42 AM
 
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No advice but : : : !!

and yes i would try and get them to resubmit with a different code, or maybe you can get the doc to sign off on it that it's a necessity.

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