Another "healthcare" rant: has this happened to you?

[Trailrider1951]

At the end of September, I became very ill with a stomach virus. I went to see a doctor at a local clinic, as it was too far to drive to see my regular doctor. I checked online to make sure that this doctor was in my insurance company's list of preferred providers, and made an appointment. When I went to the clinic for my appointment, I checked in at the window and gave them my insurance card. I WATCHED the person who checked me in make a PHOTOCOPY of my insurance card. That copy went into a folder with my name on it. I saw the doctor and then went home. Fast forward two weeks to yesterday, when I pulled a letter from this clinic out of my mailbox. Inside was a bill for $152.00. Yes, that's right. My name was correct. My address was correct. I was given an account number, also correct. The total charge was $192.00. Minus my payment (co-pay) of $40.00, also correct, leaving a total due of $152.00 listed under "amount you now owe".

Under the box entitled "Insurance Information" is listed this: "NO PENDING INSURANCE ON FILE". WTF? This also came with a detachable return coupon with space for paying with a credit or debit card and a blank envelope.

I ask again: WTF? What happened to the photocopy of my insurance card? Gee, it must have been misplaced. Only this EXACT SAME THING HAPPENED ABOUT TWO YEARS AGO AT THIS SAME CHAIN OF CLINICS HERE IN CENTRAL TEXAS. Am I being paranoid? Or is this a method of double billing to see if they can collect TWICE? I did call the "customer service" number and gave them YET AGAIN my insurance information, and was promised that "it is taken care of". Has this sort of thing happened to your or your family? WTF!

[ejpoeta]

1. no but i was told i had no copay only to get a bill in the mail before

with the copay plus their fee for sending me a bill.

[Mass]

2. Several times. Once, I got an $8,000 bill for a surgery that was 100 % covered.

A couple other times, we got charged for visits where the referral was not made properly. All were solved on the phone, but I always wonder how many people pay without protesting because they dont know.

[bluethruandthru]

3. Just wondering...do you have a deductible that has to be met? n/t

[Trailrider1951]

5. No deductible for office visits as long as the doctor is in the

preferred provider network. I only have to pay the $40, used to be $20 until 2 months ago...

[bluethruandthru]

10. Then it's probably just standard operating procedure for that clinic.

It's probably similar to the grocery store where you notice they ring up alot of items that are a few cents higher than what the price on the shelf was. Not enough to make you stop the cashier and hold up all the other shoppers while they check each item and void the purchase...but if 90 percent of customers never call them on it..they keep doing it and the profits are enormous. They're probably betting that many people will just pay the bill rather than fight it.

[KansDem]

4. I was billed $750 for lab charges because someone IDed as "F" when I'm an "M"

My doctor ordered some lab work to be done. Somewhere in the paperwork, someone put me down as a female instead of a male. Of course my insurance denied the request and it went back and forth with me on the phone with my insurance company, doctor's office, and lab.

It went to collections and was finally cleared up after considerable time had passed.

"Best health care in the world," Bob Dole, 1996.

[JuniperLea]

6. Couple of things...

You must also confirm with the provider that they are STILL on the preferred provider list for your insurance company.

Get a copy of the generic insurance form your provider submits to insurance companies. It will include the billing codes needed for processing your claim. Find a claim form from your insurance company and submit it with the provider's signed form attached.

Wait for the EOB from your insurance company. It will confirm without question if the provider is a participant with the plan, and it will tell you what you actually owe the provider based on this information.

I'd fight it out with the provider until the EOB arrives; most of health insurance companies make the EOB available online, so you might check to see if yours does... and if that provider has already submitted a claim.

This happens all the time. It's not necessarily crooked behavior, sometimes it's just stupid people doing an administrative job they are ill-suited for and shouldn't be doing. Best advice: do not wait; do it now.

[sharp_stick]

7. Yes it has

to me and to my kids at the Dentist. Phone the billing department at the Drs. office and make sure it gets straightened out.

At my Dr's office one hand has no idea what the hell the other hand is doing and the insurance is often "forgotten". I think it's the office staff just being lazy and refusing to look in or call the reception area if they can't find the info right away in their files.

Drives me up the wall, we finally told our kids Dentist that we were going to find another one if they didn't straighten this out.

[Statistical]

8. I NEVER pay any bill until I get an EOB (explanation of benefit) from insurance company.

I would chalk it up to an inept and overly complex Health care system rather than any wrong doing.

[Bitwit1234]

9. Well I had gone to an eye doctor

and my insurance covers eye care, so does Medicare, when it is connected to cataract visits. I got a bill from the doctor saying I owed $25.00 because my insurance didn't cover some sort of eye exam they gave me. After telephoning back and forth I sent them the payment. Then I got the Medicare statement of monies paid. On the form they had paid $14.00 of the bill. My insurance did not pick up the rest. So I then got a bill from the eye doctor for the remainder of the bill, and my insurance company had sent me the check instead of the eye doctor. So I deposited the check and wrote my personal check minus the $14.00 that had been paid to the eye doctor. FOR FIVE MONTHS THEY KEPT SENDING ME BILL AFTER BILL AFTER BILL FOR THAT $14.00. I took all my papers and receipts to the office and showed them they had been paid by me and the insurance company. They wouldn't accept my explanation. So I gave them the check for the $14.00 and told them to take me off their books because I would never visit their office again. That they were crooks. My internist keeps telling me to have my eyes examined by this doctor because of my diabetes and I refused. I then told them to find me another doctor to set up an appointment with and explained what happened. It was only $14.00 dollars but hell if they do stuff like that I consider them crooks.

[uppityperson]

11. It has happened and is part of the insurance "game". Make a copy of card, drop it off or send it in

It isn't a double billing unless ins co pays and you do and you will get an Explanation of Benefits (EOB) from your ins co for every payment they make or deny.

I've been receiving a bill for labwork since ins denied as "pre-existing". Ins co said they sent request for info to clinic, clinic said they never got it. It took 6 months of persistent phone calling to both places to get it straightened out. Every month I'd call the ins co to ask why denied, every month they said "waiting for info from provider", every month I'd call provided and tell them that, every month provider billing would tell me they'd take care of if and put a note in my file that I'd called again so as to not send me to collections.

6 months later ins paid.

Make sure you call the billing place every time you get a bill to keep on top of it. Insurance is legalized gambling and if they can avoid paying money out, they will. Just because a clinic took a copy of your ins card doesn't mean it got entered into their billing program. When you call, ask them what insurance is listed on your file. They will look it up and if they say "nothing", then give them the info again.

[Crunchy Frog]

12. I wonder what the monetary worth is

of all the time that is wasted dealing with this kind of shit. I wonder what the yearly per capita medical expenditures would be if that were factored into the equation.

[xchrom]

13. +1 -- the hours spent per family/individual wasted

'managing' this crap really does have an un-calculated price tag.

[Crunchy Frog]

14. I wonder what the monetary worth is

of all the time that is wasted dealing with this kind of shit. I wonder what the yearly per capita medical expenditures would be if that were factored into the equation.