Over the next 2.5 weeks, I am on vacation. Sadly, in my pathetic world, that means I will be still reading email and even, perhaps, posting to the blog. In order to stretch out my effort, I am going to run a series of quick appeal letters and a patient waiver related to the recent data I shared about pediatric usage of hearing and vision screens.
The first letter is straightforward, effective, and, in the words of the generous practice who sent it along to be shared (thanks, Bonnie!):
I keep quiet most of the time, but I thought I would respond to your question regarding reimbursement for vision and hearing.
We have been charging for the vision for many years and at one time were being paid something over $10 by a few companies. So many of the ins.cos. bundled it to the office visit. Now we have every parent sign a waiver giving them the option of having their vision tested by us or seeing an eye doctor. If they opt to have it done here and their ins.
does not pay, then they agree to pay $30.
For code 92552 and 92567 we are reimbursed between $18 and $23. There are some ins. plans that show these as "non covered" services and the charge is passed on to the parent. Some ins plans try to bundle the code to the office visit. I have two great appeal letters that work very well for getting them to change their minds. UHC has only certain Dx codes you can use and be paid for the hearing screens.
First - thanks, Bonnie! Awesome. Here is her first letter, in OpenOffice, Word, and PDF formats. A complete Audiogram 92552 Appeal Letter.