Novant Health

Wrong coding for services. Novant refuses to correct Due to daily contact with the public in my employment I was exposed to positive people with Covid-19 on a few occasions. I required testing due to exposure and my primary care physician (PCP) did not provide testing. His office instructed me to seek one of the hospitals who provided testing. I found Novant's drive-thru testing to have the earliest appointments. I made an appointment. Upon arrival I provided them with the information that included I was being tested due to exposure to someone who was Covid-19 positive. Each time I was tested I provided the same information. Two of my tests Novant did not provide the proper coding for my insurance company to cover the test. When pointing out the mistake to Novant they have refused to change the coding to the proper code by adding "CS" to the record. Over time they have refused repeatedly and have declared that Blue Cross Blue Shield of North Carolina (BCBSNC) correct the record. BCBSNC has told me directly that Novant has to correct the record. BCBSNC has also called Novant's billing department to discuss but Novant has refused to respond to them according to BCBSNC. Additionally, BCBSNC has added two colorectal cancer screenings to the services provided at their drive-thru Covid-19 testing locations. When I inquired with Novant about those notations I was told by one of their representatives that BCBSNC required that to be added to all of the services provided to someone in my age group. When I pressed and asked the Novant representative why then it was only on two of the screenings and not all four I was not provided with an answer. She told me that I requested the screening when I met with the providing physician. I called her on that let her know that never did I meet with a physician at the drive-thru Covid-19 testing. She told me according to their records I did meet with the physician. Yet another blatant lie from the Novant representative. Upon calling and talking with someone at BCBSNC they unequivocally told me that BCBSNC had no requirement for any provider, including Novant, to add on a colorectal cancer screening when it was not performed. Novant continues to refuse to remove the colorectal cancer screening from my record and perpetuate their false claim that I requested the exam along with the claim I did not state I had been exposed to Covid-19 and that was why I was there for drive-thru testing. On one of the Covid-19 screenings I went with another person in the same car. We both reported exposure to a positive person. We were each coded differently for the Covid-19 test and both received colorectal cancer screenings. Such a screening is quite awkward in a drive-thru setting. Especially when two people are in the same vehicle and are not allowed to get out of the car. (That, of course, is hyperbole to show that Novant is incorrect in their billing.) Novant's unwillingness to correct the record on coding in the Covid-19 tests is negligent at best. Their coding for tests not conducted could very well be fraudulent. Novant has been given four opportunities to simply correct the record. They have refused each time and get more and more belligerent with each request. Novant has told me that all of the tests were coded the same way. According to BCBSNC two were coded with the "CS" and two were not. Novant has indicated that BCBSNC is not telling the truth. However, BCBSNC paid those two coded with "CS" and I am not being billed for those. For whatever reason Novant continues to add to the problem by adding false statement after false statement.

I am being billed for a service that is provided without charge by Medicare. I am being unfairly billed (Novant Acct#XXXXXXX) for an outpatient hospital visit and an EKG. I am on Medicare, Part A & B and Tricare for Life. On 9 December , I had an appointment in my primary provider's office for a Welcome to Medicare visit, yet I was billed for an outpatient hospital. An EKG was part of the Welcome to Medicare visit at my provider's office. Per the Medicare.gov website, a Medicare enrollee can receive and not be charged for the Welcome to Medicare introductory visit only within the first 12 months of being enrolled in Part B and that you should "Bring to the visit your medical records, family health history, and a list of prescription drugs, over-the-counter medicines, and supplements you are taking. Your doctor will record and evaluate your medical and family history, current health conditions, and prescriptions, and make sure you're up-to-date with preventive screenings and services. ...Part B covers an EKG or ECG (as a one-time screening with a referral from your doctor as part of your "Welcome to Medicare" preventive visit and as a diagnostic test.)" I have messaged Novant's billing department no less than 10 times and spoke to someone on the phone more times than I can remember. I also contacted Medicare via phone call and chat several times. I received an answer via phone with Medicare that I am being incorrectly billed for the visit on 12/9. When that failed to impress the Novant billing department, I contracted Medicare.gov on 2/12 and got a chat message from Medicare stating that, "Also from 12/9, there is a claim that was billed for $148.00, which is being rejected by Medicare. It was for Dr. John Weathers, and it was for the doctor's portion of the office visit, and an EKG. It shows it is being rejected by Medicare because there is a billing mistake. It says the place billing the claim is different than the provider who is on the claim. You are not responsible for the charges on this claim. A rejected claim like this means we need the provider to correct the claim before it is fully processed. This is claim number XXXXXXXXXXXXX. It shows they aren't allowed to bill you for anything on this claim." I sent this information in writing to Novant billing, vi*** account. When I received the same we-have-reviewed-and0-you-are-wrong-and we're-not-budging type of response, I once again contacted Medicare via chat on 3/5, and was told: "I am showing claim XXXXXXXXXXXXX from 12/9 is in a rejected status, which means the contractor has returned your claim to your provider because they need more information to process and pay your claim. Your provider needs to complete the missing information and file the claim again...If that provider accepts Medicare, but refuses to make the necessary corrections and resubmit the claim, you can call 1-800-MEDICARE and a representative can submit an assignment violation because that provider is required by law to submit claims to Medicare." I have been advised by Medicare not to pay this bill and that this agency is in violation if they even bill me for this visit. Yet, Novant continues to reply to my requests to resubmit to Medicare with what I can only describe as a "canned" reply that they have reviewed my record, made no errors, and will not resubmit. I receive monthly statements in the mail for a hospital visit on this date. I have taken one of these bills directly to my provider's office to ask for help and was got no further than the front desk where I was told "it is not my job". I even called Novant again to tell them that my spouse is covered by the same insurance and was not billed for his previous "Welcome to Medicare" visit. I am at a loss with how to communicate with these people, and I feel certain they plan to turn me over to collections. If I pay this bill, which is not even legally charged, I expect that whatever Medicare billing errors this agency made in my account will become the norm. Can you please help?