Healthcare: Billed for downloading CGM

I’m not sure if this has already been discussed - I didn’t find it in my topic search.
So, my family recently relocated to a new city and I had my first appt. with an endo. When I received the EOB a few weeks later, I was startled to see a separate charge was listed for “Glucose Testing”. They did not test my glucose during the appointment, so I called to find out what this referred to. Apparently there is a separate charge for the office downloading my CGM, even though I had also printed and brought in 3 weeks of downloaded data.

What have other people experienced, in terms of fees for this? This struck me as kind of unfair.

That’s not just unfair, that’s ridiculous. I’d be refusing to pay that one, or looking for a new endo.

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I would tell the endo that unless he/she gets rid of the bean counter who dreamed up that rule, he/she is going to lose a lot of patients.

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I assume that before I meet with any medical professional for a scheduled visit, that they have reviewed my chart and are prepared to discuss past, present and future concerns. Most reasonable people would assume that background preparation and those discussions are part of the “office visit” for which I and my insurance company have a tortured set of rules to determine who pays what proportion of that charge. But it is a single charge, not some aggregation of “getting ready,” “actually talking with the patient,” “doing followup” etc. Since we all know downloading the CGM data is a trivial matter, this would hardly seem to rise to the level of some different, separately-codeable “procedure.”

I saw such a charge on my last bill with my old endo, as well – and my insurance denied the charge for failure to get prior approval! Note: I was never billed for the unreimbursed charge, and would not have paid it, had I been charged.