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Friday, March 9, 2012

More Medical Billing Woes: The Saga Continues

Awhile back I shared my woes with a year old tale of how one simple screw up with a service provider led me into a world of fail that continues to plague me.

Brief recap… My wife had a doctor visit on one day with Provider A and on the next day had some additional tests done by Provider B. Having a deductible of $250 to fulfill, we were billed $71.50 by Provider A. Provider B billed us for $250 for their services.

Never getting the full disclosure of what we were being billed for in an Explanation of Benefits, I opted to hold off on paying Provider A and B because there was a discrepancy in the amount being billed.

Long story short, I eventually paid Provider A for $71.50 and then $178.50 to Provider B, thus fulfilling her individual deductible of $250.

Then, Provider B continued to bill us for the remaining $71.50. I disputed it and they didn’t care. I contacted Provider A and they could not provide me with an answer. I contacted the Insurance Provider and they could not find any claim other than the initial co-pay of $20 for Provider A’s visit.

We were sent to collections. And when the collection agent called last week, I explained all of this and then had to make another round of calls to Provider A, Provider B, and the Insurance Provider.

Provider A is not open for inquiries beyond 5pm. 4pm for Provider B. Calling them after work is not really an option. Hell, it’s hard to get through to them during my lunch, because I’ve sat in the hold queue for well over 20 minutes and this issue takes time to re-explaining.

So, I called yesterday after going through my training class and needing to decompress… Of course, I attempted to apply what I learned about Service Management to the CSR over the phone. It didn’t go well. This is a paraphrased conversation.

“How did this happen?”
  “No claim was filed for this service.”
“Yet you billed me for it.”
“And I paid for it.”
“OK, well, I’m into collections with another provider over this, so re-file the claim.”
  “It will take 7-10 days to do this because we have to pull it from collections.”
“Seriously? 7-10 days?”
“But you billed me for it and didn’t file a claim with the insurance. Why do you think I didn’t pay it? Because no claim was filed and no EOB was sent out for it. What if I had already met my $250 deductible before this? How would you know that I owed anything? You billed me before filing a claim.”
  “I understand that sir. It will take 7-10 days to file it because we have to pull it from collections.”
“OK, well, I called last year and went over this with someone and they said they would re-file it. They obviously didn’t do it. So, what kind of assurance do I have that it will get done this time? Can you send me something or copy me on the statement.”
  “No, sir, I cannot do that. You can call the Insurance Provider in 7-10 days to see that it was filed.”
Let’s just say I don’t have a lot of confidence that this will get done. The last time I called they said they had to get a hold of a supervisor and call me back.

They didn’t.

Once this gets resolved, I want a friggin’ apology from Provider A.

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