So please give me advice on a related issue.
We treat a lot of patients for hepatitis C. The course of treatment is challenging, both for the patient and for the provider. It is also very rewarding when it is successful (which is now usually the case). The meds are also incredibly expensive, so we expect some diligence on the part of the insurance company to be sure that the patient is an appropriate candidate and will be getting the appropriate follow-up care. We have been doing this for some time, and we know that there are a number of administrative hoops (some reasonable and some rather arbitrary) that we must jump through. We are prepared to do so.
On the other hand, in some cases the requirements are so onerous, variable, and arbitrary, that to me they seem clearly designed to prevent the insurance company from providing the required benefits.
Friday was a day off, but I was in the office when a hepatitis C patient knocked at the door. Several people in the practice had already spent hours trying to get the medication for him. I told him to have a seat, and I proceeded to spend 93 minutes on the phone dealing with a rep and then her supervisor. We dealt with a series of administrative issues, some of which are really crazy; I won't bore you with the details. I will be enumerating those in my letter to the state insurance commissioner.
We have already had some discussions about how to recoup something for all of the administrative time spent on these issues. There is no way that the patient is responsible for this cost; this is different than charging for an FMLA form. Any reimbursement to us should come from the insurance company which creates this meaningless work.
So my specific questions: since the patient was sitting there, can I bill a 99215, saying that "over 90 minutes was spent in direct contact with the patient"? How else should this be documented? Can you tell me more about the V68.9 code Bill mentions? Anyone using it? Getting paid for it? Is there any way to bill the insurance company for our time spent on this ridiculousness if the patient is NOT in the office?
