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this post was submitted on 08 Nov 2024
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Billing codes are purposely complicated to deny legitimate claims a lot of the time. Two nearly identical codes will have one covered and another not for whatever reason they come up with. It's why there are entire teams to handle billing at large institutions.
The real question honestly, is if those individuals were authorized to give shots, are there different billing codes that should have been used instead? And if not, why?
This happened in Canada, not the US, but I agree with the US healthcare issues you mentioned
Canada is the same, just single payer (ie instead of hospitals billing the insurance company, they bill OHIP). There's still complicated codes, though for what it's worth they don't change much, if at all. If you're billing thousands of shots you'd probably want to double check you're using the right codes.
The Canadian Healthcare system isn't that different from the US as much as you all might want to think it is. You just have fewer groups paying, the bullshit complexity built into the system is a near copy of the US.