Charlotte family claims they were billed hundreds after coding error

Billing error charges family hundreds

CHARLOTTE, N.C. (WBTV) - Imagine going to meet your new doctor to establish care and then finding out you were actually billed for something different.

It should be a simple correction right?

Well, think again.

After months of battling with his hospital, a Charlotte man turned to WBTV for help.

“At this point, it’s just frustration and anger that impacts me the most,” Jacob Byers said.

Byers, for five months, has been arguing with Atrium Health.

On March 11, his daughter went to Atrium’s Riverbend Family Practice at Mountain Island to simply “establish care.”

He thought the initial visit for $183 would be covered by insurance.

However, Byers was surprised to learn the claim was rejected by Blue Cross Blue Shield Federal Employee Program.

Confused, he challenged the bill and the balance increased to $262 in June.

“At that time, we challenged that bill and contacted our insurance provider who let us know that the coding was incorrect - that they would not be able to pay out that bill due to a general coding being used,” Byers said.

It turns out the bill was apparently coded by Atrium for “persons encountering health services and other specified circumstances.”

“To me, that’s what blew me away is that they say, ’other specified circumstances’ and did not specify the circumstances in which she was seen, which of course, was to establish care,” Byers said.

Blue Cross Blue Shield told Byers the coding used should have been “to establish care.”

With the correction in hand, Byers contacted Atrium, but once again, the coding was denied.

“Some of my remedies, I was told were to retrieve the doctor’s notes from that visit as well as to seek medical record change to have that code changed,” he said.

WBTV sent the doctor’s notes and the specific reference “to establish care” to Atrium for an explanation. Atrium has still refused to answer our questions but immediately contacted Byers.

“They realized the ball had gotten dropped on this one - that the coding they used, while it’s typical for the type of visit that my daughter received which was to establish care, it didn’t fall in line with the BCBS guidelines for what they will pay out for that type of visit,” Byers said.

Tonight, five months since it all began, Byers says Atrium changed the code, leaving just a $30 co-pay.

“A big thank you to the WBTV family out there for getting back with us. Honestly, I wasn’t expecting it,” Byers said. “I reached out to you guys in a moment of frustration but to see the follow-through and to know we got resolution and attention brought to the situation is absolutely rewarding.”

Copyright 2020 WBTV. All rights reserved.