u/Several_Pizza_3166

I recently had a UC visit where after giving my initial intake info, a doctor came in and told me the clinic I was at was a sort of mini-urgent care that was not equipped with the diagnostic equipment for my symptom. She then said the local hospital would have said equipment, and that she would put in an order (if that's the correct term) for a test there for if I wanted to get it done.

Anyways, the doctor did not examine me or ask me any questions. This appointment was billed as 99215 on the basis of medical decision making, and specifically because a "decision regarding hospitalization" was made. That's just what a billing rep said after a quick look at my file. Upon googling, it seems like that phrase refers to cases where a provider has a patient urgently admitted to the hospital. My situation was more of a 'this is actually a mini urgent care without much equipment, if you want x equipment you could get that done at x hospital' type thing.

Idk anything about medical billing (obviously), so I'm not sure what information is relevant to include here. But tldr, I'm trying to figure out if the correct billing code was applied / if "hospitalization' does in fact include being referred for imaging at my leisure.

I recently went to an Urgent Care clinic that is in the same health organization I usually go to for primary care, but I have not been to this specific clinic or provider before. I was confused upon seeing the cost of my appointment, so I googled the code. It seems that 99215 is the code for establish patient visits that are 45+ mins long and/or deals with life threatening illnesses.

I called patient billing to ask about this and said I feel this code was not right as I was in the doctors office for less than 5 minutes, but the representative just said 'well that includes the entire time they spent, not just the time in the room'. Which I understand.... but idk, I was there for 5 mins for one symptom and a completed chart was posted on my patient portal in the time it took for me to walk to my car. The doc didn't even examine me or talk to me, he just told me they did not have the equipment necessary to help me there (which I assume he based on my intake info).

The patient rep made it sound like it is hard to get this changed based off time as it's kind of my word against theirs, but then I read something that makes it seem like "established patient" would also not apply as I had not been to that specific clinic before?

Honestly idk exactly what info is relevant to include, but I'm trying to figure out 1. if this billing likely is in fact wrong, and 2. what things would actually be provable / usable in getting something changed? Thanks in advance.

I recently had an urgent care appointment for an eye injury that seems to have been documented incorrectly, and am wondering if / how that plays into billing. The appointment consisted of the CMA taking my vitals + basic info, followed by the doctor popping in for a second to tell me I'd need to be seen in the ER.

I looked at the visit documentation online, and my complaint summary was wrong + info for a full physical exam (which they didn't do) were input. (Edit: added the following) The documentation says I reported having experienced severe disorientation the previous night and awoke with sudden vision changes, plus has values input as if I was physically examined by a doctor. I just said I injured my eye that day.

Anyways, my question is whether it being documented that I was physically examined by a doctor + that I was evaluated for multiple symptoms would cause my appointment to be billed differently.

Edit: I put 'nurse' in the title when I should have said CMA

Edit: added the medical issue I was there for, sorry I did not realize that was relevant to how appointments are billed