(My company does billing work for various doctor offices. This includes sending out claims and posting payments. A lot of claims come back denied for whatever reason, and we deal with correcting those as well. When we get new people, someone goes through their work before updating their batches to make sure things don’t leave with an error, since they are new. I only post payments, but if something looks strange on a denial, I’ll ask someone who does claims. I just happen to see something strange with a denial.).
Me: Hey, do you know any reason that an office visit would be billed out at $27,500?
(While our billing prices are higher than what’s normally paid, if you bill out an excessive price like that, it will pretty much always deny, requesting info as to why it was billed out so high. Normally, office visits are billed out under $150 depending on how long the visit was, and insurance pays about $40-100.)
Co-worker #1: Did you check the claim?
Me: I tried, but I see nothing on here to indicate it, maybe you can look since you know these things better?
(He comes over and looks. He sees no reason it was billed that way. I checked to see who posted the claim, and noticed it was a trainee. Even if it wasn’t, it’s something I have to show my supervisor. I go to her office.)
Supervisor: What’s up?
Me: I wasn’t sure how to explain this in an email, but can you look up (claim number) under (doctor’s database)?
Supervisor *does so* What the hell are they billing out for that price!?
Me: It’s an office visit. The batch is one from (trainee).
Supervisor: *looks at details* This is partially my fault. I should’ve known better than to let (co-worker #2, who makes several errors himself) check it.
(Turns out that the office visit was so high because the trainee put 211.9 units of office visits in! There was absolutely no reason that shouldn’t have been caught before sending. I’m sure that coworker that checked the work got an earful that night! Just glad that it wasn’t a self-pay visit that went out…)