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What
Are Dual Procedures?
A Dual Procedure is when any doctor corrects more
than one aliment during a single operation. These
type of medical procedures provide the greatest
amount of safety for the patient.
Why?
Anytime an individual requires any form of
anesthetic, there is always some risk of
uncertainty. When Dr. Lauersen performed
a Dual Procedure he
was able to minimize cost and increase patient
safety by limiting the number of surgeries required.
Dr.
Lauersen's innovative techniques outraged
the insurance companies. There were no billing
codes in existence to bill the insurance carriers.
More than 100 times, Dr. Lauersen and his staff
attempted to obtain a billing code for Dual Procedures
but the carriers refused to assign the necessary
codes for billing purposes.
At
the second trial; a representative from one
of the insurance companies testified that they
do issue codes for Dual Procedures. During my four
years of working on this case, all the insurance
carriers where called numerous times. Blue Cross
Blue Shield told Dr. Lauersen that they could not
send him anything in writing. Instead they told
the doctor to use this code or that code,
whatever code he thought was correct. No
codes existed to cover Dr. Lauersens dual
procedure treatments. In Court they had a
respresentative testify that Dr. Lauersen
never requested a Dual Procedure Code which
was blantantly untrue.
Throughout
his practice; Aetna/U.S. Healthcare would
fax Dr. Lauersen surgery
confirmations and then refused to pay for any of
the operations. This was the beginning of the set-up.
The largest case of
insurance malfeasence since the Colonial
Penn/AARP debacle of the 1970's.
The
insurance companies had now found a way to
get doctors to work for free. They
would request that a patient's entire medical file
be turned
over to the insurance carrier to evaluate the need
for the surgery after they had provided a faxed
pre-approval. This was intentional misrepresentation
on the part of the insurance carriers to defer
making payment and violate patient privacy under HIPPA.
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