i contacted the plan regarding sequestration payment that was not identified by service line as specified my Medicare. I was provided the information because i demanded that they provide a line item amount versus a overall amount. I then asked to speak with a provider service representative and was told we were out of network and no help was available. I asked the representative why do i have a check for a office visit if the provider is not in network. I asked the representative to check by the rendering provider and he was in network, I then asked how can the doctor's corporation not be in network but the doctor is in network since 2012... I signed the contract and payments are being sent to the corporation.
The reason i actually called was because the sequestration was being taken as a single item versus a per line item as it is outlined in the Medicare guidelines. All that i was given was the e-mail address of the provider relations representative because they do not take calls.
i have the Medicare job aid regarding sequestration and item 7 clearly proves my point, just tell me where to send so you can fix this issue.
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