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Friday, January 20, 2012

Medical Billing Makes Me Angry

This has been a ridiculous six months.  Honestly, I am so grrr filled that I need a few hundred puppies to kick, STAT!

Back in July, my wife had a doctor's appt.  One of them.  The kind, us guys, don't talk about.  Anyway, there was lab work to be done and I received a bill for $71.50.  The next day or so, she had MRIs taken at a hospital that belongs in a different health care system, supported by my medical benefits plan.  That bill came to $250.

Now, through my benefits, I have a $250 individual deductible as well as my wife.  So, after paying $71.50 to one provider, I should only have to pay the difference, $178.50, right?  So, I did that. 

About a month later, I got a bill from provider number two, looking for the remaining $71.50.  I mailed it back, using their mailer with the words, "Paid $71.50 towards deductible, already. Only owe difference."   Then a month went by and I got another bill for $71.50.

Feeling a bit perturbed, I called provider number two and told them why I did not pay the additional amount.   They didn't care.  I then called my Insurance Provider and they said my deductible was met and that I didn't have to pay it.  So, I called back provider number two and told them that and they didn't care.  They said that the deductible didn't matter. They insurance provider sets that.  I said, "I know.  I paid it and they said I wasn't liable for anymore."

So, I hung up on them and called provider number one to figure out how this all got screwed up.   They told me that there were no claims against my insurance.  I said, "Well, then why did you bill me?"  They didn't know.  They said that they found the services that were billed and would resubmit that to the insurance provider.  I said thank you and called back my insurance company.

They said, "OK. Once we get it, we'll send an adjusted statement of benefits and let provider number two know."    I thanked them and put the matter aside.

I got another bill last week.

So, I called back the insurance provider, which I no longer have because my employer decided to go with the lowest bidder for services, and they said no claims were made against my benefits but that my deductible was met.  I explained what the service was for, hoping for them to be able to find it and they couldn't.  They did, however, say that the particular lab work that was involved was covered under our plan and that my wife should have only had to pay the copay, not another charge.

I then called provider number one back to find out what the hell happened to all this.  They couldn't help me other than to say, the account was paid in full.  I said, "I know.  Why did I have to pay for this?  What was this?  My insurance provider says that this particular test should have been covered under my plan.  I have another provider looking for money because I paid you."

They couldn't tell me.  They had to speak to my wife or have her consent.  I said, "Why?"

She said, "HIPPA."

"Look, I am the policy holder.  It's my wife.  I gave you her SSN.  What else do you need?"

"Her consent."  She said.

"I know it's a damn pap smear!"  I said, "Well, then you can hold on for five minutes because I'm currently driving home and she will give you the consent, because I am sure not waiting another 20 minutes to talk to someone."

I got home, my wife gave consent and they told me it was for a pap smear.

They also couldn't help me because the customer service rep's supervisor stepped away from her desk and she would know why I was 1. Billed.  2. Not showing it on my insurance claims.

That was at 2pm.   By 4pm I heard no word back.   Apparently, the supervisor got lost or because the bill was paid, they don't care.

In any case, if they billed me incorrectly, they need to pay me back so I can pay provider number two.   OR  They need to submit their damn paperwork properly so this shit doesn't happen again.

This is 2012.  How hard is it for the hospitals and insurance to fill this crap out correctly?  I mean, if I had paid the $250 bill first, these idiots would be after me for $71.50.  Technically, they would be in the right because that service was provided first.   However, if they were not supposed to bill me, then everything would be fine and they could kiss my ass.

Why do I have to take time out of my day to investigate their mistakes?  Why do I have to call at inopportune times because they only have hours until 4pm?  I work until 4pm.  If this is what being an informed consumer is like, I'd rather go put my faith in Muck-a-luck the witch doctor and leeches.

Get your shit together and call me back.  I'll be sure to put you on hold while I think about all of this.

4 comments:

yovan said...

Hey, nice site you have here! Keep up the excellent work!

Medical Billing

Blackberry Repair said...

As much as three quarters of hospital staff are usually burdened with some sort of billing-related work in a traditional billing system. Opting for electronic medical billing solutions (ones that come with free EMR plans) that fit easily into the healthcare business' workflow are key to freeing up staff resources.
Medical Billing Services

Mongo said...

You still have to have staff to oversee that sort of thing and unfortunately, they can muck up the system or be completely ignorant of computer snafus when they happen. Give me live, trained, credible bodies dealing with my money and healthcare.

Mongo said...

Update to this in a new post.

They original provider never filed a claim with the insurance company.

So, how can they be sure that I would have owed anything? Don't they file a claim and have the insurance provider tell them how much I have left on my deductible and that's what I get billed?

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