Little confused with billing
Hello, I'm currently confused.
Insurance is through Husbands Job. It Cigna PPO.
They have a limit of 20 visits of Physical Therapy.
I've gotten confusing anwser from each of the people ive spoke to about my insurance. (Both in their portal) One stated its a hard limit basically, it was all they'd pay for. I have used 1 of the 20.
Other said doctors could request more.
Still part of what has me confused, they have approved and paid for multiple appointment. But only one of the appointment was billed under the code that showed on the EOB as PT. It was the original appointment with my therapist. Every appointment since has been shows as "Medical Care"
I have a referral where the doctor recommends I do this. When I attempted to Google it, my understanding was sometimes if deemed medically necessary. They can code it as this? It might not count toward limits?
I couldn't find this reflected in whatever that thing is called that displays like the rates/co-pays for certain services. I can't remember its name right now.
The appointment, I mostly have one of the assistants working with me. (Telling me what exercise to do in what order, etc.) If a new one is added, the therapist is the one who shows me. But he also spends about 10-20 minutes at the end.
I assume there is no issue with how they are billing if its happen to be billed the same way for every appointment. I'm just confused. I don't want a suprise correction later on down the road where Im expected to pay this back.