April 10, Dear [redacted] , I am responding to the complaint that was forwarded to you about a bill for one of our patient encounters in our dermatology officeThe patient states that he was overbilled for an office visit which required an evaluation and management codeHe states that he spoke with someone in our office prior to his visit and was told that the code would range from ***-***, and he was ultimately billed a for evaluation of multiple skin lesions by my physician assistantHe is upset because he wanted to be billed the lowest code, stating that the physican assistant saw him for minutes.Firstly, I would like to inform you that the patient was seen by my physician assistant and I have never met him or spoken to himI have taken the liberty of forwarding his office visit with his name redacted to a certified dermatology coding analyst at the American Academy of DermatologyI have also taken time to speak to her personally on the phone after reviewing this chart with herHer conclusion is that the information that was documented does warrant a code of ***However, she feels that based on the relatively moderate to low complexity of the patient’s condition as documented in this note, she can understand how it could be downgraded to a [redacted] or possibly a [redacted] The amount of face to face time in an encounter has no bearing whatsoever on the ultimate code that is chosen, as the patient claimed in his letter to youI feel objectively that the documentation of his visit warrants a [redacted] codeHowever, I can understand the patient's frustration given that his encounter was brief and the level of complexity of his visit was not highI will therefore apologize and resubmit his claim as a [redacted] to his insurance companyPlease set me know if this is satisfactory to himThank youSincerely,William A, MD
April 10, Dear [redacted] , I am responding to the complaint that was forwarded to you about a bill for one of our patient encounters in our dermatology officeThe patient states that he was overbilled for an office visit which required an evaluation and management codeHe states that he spoke with someone in our office prior to his visit and was told that the code would range from ***-***, and he was ultimately billed a for evaluation of multiple skin lesions by my physician assistantHe is upset because he wanted to be billed the lowest code, stating that the physican assistant saw him for minutes.Firstly, I would like to inform you that the patient was seen by my physician assistant and I have never met him or spoken to himI have taken the liberty of forwarding his office visit with his name redacted to a certified dermatology coding analyst at the American Academy of DermatologyI have also taken time to speak to her personally on the phone after reviewing this chart with herHer conclusion is that the information that was documented does warrant a code of ***However, she feels that based on the relatively moderate to low complexity of the patient’s condition as documented in this note, she can understand how it could be downgraded to a [redacted] or possibly a [redacted] The amount of face to face time in an encounter has no bearing whatsoever on the ultimate code that is chosen, as the patient claimed in his letter to youI feel objectively that the documentation of his visit warrants a [redacted] codeHowever, I can understand the patient's frustration given that his encounter was brief and the level of complexity of his visit was not highI will therefore apologize and resubmit his claim as a [redacted] to his insurance companyPlease set me know if this is satisfactory to himThank youSincerely,William A, MD