Aetna has added new information to its health insurance benefits statements that might enable members to identify billing errors or physician fraud, according to a Consumer Reports report.
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
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