Hello,

I realize this is not an insurance SR, but this is one of the better places I know to ask this type of question. I apologize in advance -- if there's a better SR to post this, I'd love to know

I recently received a bill for services rendered at a specialist (neurologist). I was charged for the following:

99204 E/M Svc New Pt Level 4

It looks like this code is for spending ~45 minutes with a new patient and for a 'complex' issue. A nurse asked PHI questions which I already answered previously, which took about 5 minutes. The Doctor visit itself only lasted about 15 minutes. My appointment was for 2PM and I was not called back until 2:30, and not seen until 3:00 and left the office at about 3:15PM.

Is this a case where someone may have fat-fingured entering the CPT code? They already billed (and got paid by) my insurance. Whom do I speak to about this? I don't want to get them in trouble as I realize mistakes happen. If there is indeed an error and they fix it, I'd be very surprised they would ask me to pay a bill.

They billed my insurance $920, of which insurance covered $388.19, leaving my responsibility left of $531.81. This seems extremely high. I am on the East Coast in a high COL area with a COL index of ~123.

Am I correct in my thought process? All of this seems ridiculous.