Beginning on Nov. 23, Aetna has added extended service code descriptions to the explanation of benefits forms it sends members, in addition to CPT codes. Healthcare providers can potentially overcharge patients and insurance programs by “upcoding” procedures with the wrong CPT codes.
By including codes on the EOBs, Aetna is hoping to reduce incidences of upcoding, though the information may not be useful to patients without additional research.
Read the Consumer Reports article on Aetna EOB statements.
Read more on coding and billing:
–Surgery Center Best Practice: Send a Letter Prior to Service
–Best Practice: Physician Coding for ASC Procedures
–Practical Guidance on 3 Top Revenue Cycle Challenges — OON Payors, Denials and Collections
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.