# Health care horror story #13848732 **URL:** \ **Category:** The BBQ Pit\ **Created:** [December 26, 2009, 8:01am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612 "2009-12-26T08:01:41Z")\ **Posts on this page:** 20\ **Page:** 13
**Author:** ![Sinaijon](https://avatars.discourse-cdn.com/v4/letter/s/dc4da7/32.png) [@Sinaijon](https://boards.straightdope.com/u/Sinaijon)\ **Post date:** [December 30, 2009, 10:12pm UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/241 "2009-12-30T22:12:20Z")
> [@Really\_Not\_All\_That\_Bright](#): > > They called back. They asked if I knew the billing codes for these procedures. I obtained same from my physician, and called back. > > They _still_ didn’t know. That sounds pretty fishy. I have a hard time believing they couldn’t tell you, given the billing codes, since that’s how they’d actually do it. ---
**Author:** ![kaylasdad99](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kaylasdad99/32/3398_2.png) [@kaylasdad99](https://boards.straightdope.com/u/kaylasdad99)\ **Post date:** [December 30, 2009, 10:45pm UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/242 "2009-12-30T22:45:17Z")
Billing codes tend to be in the bailiwick of accounts payable, rather than customer service. I’m not prepared to claim that it holds true for medical insurance companies, but IME, the accounting people don’t really feel they have much to talk about with the customer service people. ---
**Author:** ![Sinaijon](https://avatars.discourse-cdn.com/v4/letter/s/dc4da7/32.png) [@Sinaijon](https://boards.straightdope.com/u/Sinaijon)\ **Post date:** [December 30, 2009, 11:11pm UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/243 "2009-12-30T23:11:39Z")
> [@kaylasdad99](#): > > Billing codes tend to be in the bailiwick of accounts payable, rather than customer service. I’m not prepared to claim that it holds true for medical insurance companies, but IME, the accounting people don’t really feel they have much to talk about with the customer service people. The times I’ve called about stuff like this ( 3 different insurance companies, actually), they’ve always provided an immediate answer for the general case, but if I needed specifics, I could provide the codes and they would give me the definitive answer. In those cases where I gave them the codes, I again got immediate answers. If they specifically asked for the codes from **RNATB** , I have a hard time believing they wouldn’t know what to do with them. Maybe the codes were incorrect, or nonstandard, or something, but it sounded an awful lot like a bogey man argument. (“And it’s got big, sharp pointy teeth!!!”) ---
**Author:** ![kaylasdad99](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kaylasdad99/32/3398_2.png) [@kaylasdad99](https://boards.straightdope.com/u/kaylasdad99)\ **Post date:** [December 30, 2009, 11:26pm UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/244 "2009-12-30T23:26:56Z")
> [@Sinaijon](#): > > The times I’ve called about stuff like this ( 3 different insurance companies, actually), they’ve always provided an immediate answer for the general case, but if I needed specifics, I could provide the codes and they would give me the definitive answer. In those cases where I gave them the codes, I again got immediate answers. I’ve also generally had no trouble getting straight information on whether something is covered. **RNATB** ’s tale made me wonder just what insurance company this is, and whether they brought out the question about codes as an attempt to end the call by asking for information they thought he wouldn’t bother getting. ---
**Author:** ![spinky](https://avatars.discourse-cdn.com/v4/letter/s/59ef9b/32.png) [@spinky](https://boards.straightdope.com/u/spinky)\ **Post date:** [December 31, 2009, 1:01am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/245 "2009-12-31T01:01:38Z")
Hooray: I just found out I have a new $2100 issue to deal with. 13 months ago my wife had a hospital visit and due to an error in the hospital billing department, they submitted the claim to the wrong insurance company. The wrong insurance company **also** made an error and actually _paid_ the claim. 13 months later, they noticed this error and have asked for their money back from the hospital. So now I need to chase down 13 month old records and follow up with an insurance company that we are no longer customers of in order to get this claim paid. I’m sure that process will be smooth as silk. And on the theme of everything expensive going wrong that possibly can, the hospital computer system will probably do something nice like send me to collections for having a 13 month old balance. Sigh. 🙂 ---
**Author:** ![Lynn\_Bodoni](https://avatars.discourse-cdn.com/v4/letter/l/e47c2d/32.png) [@Lynn\_Bodoni](https://boards.straightdope.com/u/Lynn_Bodoni)\ **Post date:** [December 31, 2009, 3:16am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/246 "2009-12-31T03:16:45Z")
> [@Sinaijon](#): > > That sounds pretty fishy. I have a hard time believing they couldn’t tell you, given the billing codes, since that’s how they’d actually do it. Oh. Well, you see, the company actually has a policy of denying all claims, but especially claims like this. They’ll pay up if the insured person is well connected enough, or makes enough noise to the right people, but they have no intention of routinely paying, but of course they can’t come out and SAY this. So yes, they could tell you, but you won’t like the answer. So they lie. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [December 31, 2009, 3:31am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/247 "2009-12-31T03:31:16Z")
> [@kaylasdad99](#): > > I’ve also generally had no trouble getting straight information on whether something is covered. **RNATB** ’s tale made me wonder just what insurance company this is, and whether they brought out the question about codes as an attempt to end the call by asking for information they thought he wouldn’t bother getting. It would be extremely inappropriate to mention that it was Blue Cross Blue Shield of Florida, so I won’t. ETA: Note that they did pony up for the services. They just couldn’t or wouldn’t tell me if they would. Plus, my employer pays for 100% of my health insurance, so I can’t complain too much. ---
**Author:** ![kaylasdad99](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kaylasdad99/32/3398_2.png) [@kaylasdad99](https://boards.straightdope.com/u/kaylasdad99)\ **Post date:** [December 31, 2009, 3:33am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/248 "2009-12-31T03:33:44Z")
> [@ntucker](#): > > Hooray: I just found out I have a new $2100 issue to deal with. 13 months ago my wife had a hospital visit and due to an error in the hospital billing department, they submitted the claim to the wrong insurance company. The wrong insurance company **also** made an error and actually _paid_ the claim. 13 months later, they noticed this error and have asked for their money back from the hospital. So now I need to chase down 13 month old records and follow up with an insurance company that we are no longer customers of in order to get this claim paid. I’m sure that process will be smooth as silk. Why is it your problem to have the claim resubmitted to the correct insurance company, instead of the hospital’s? Be simpler to have the ins. co. that paid the claim to go after the ins. co. that _should have_ paid it. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [December 31, 2009, 4:00am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/249 "2009-12-31T04:00:26Z")
That’s how it’s supposed to work - the correct insurer reimburses the wrong insurer. ---
**Author:** ![kaylasdad99](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kaylasdad99/32/3398_2.png) [@kaylasdad99](https://boards.straightdope.com/u/kaylasdad99)\ **Post date:** [December 31, 2009, 4:07am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/250 "2009-12-31T04:07:36Z")
nm. I was talking to the wrong person. ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [December 31, 2009, 4:19am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/251 "2009-12-31T04:19:31Z")
> [@ntucker](#): > > Really? In what way has my example supported this belief? Which example is that? You have insurance. > [@Really\_Not\_All\_That\_Bright](#): > > It would be extremely inappropriate to mention that it was Blue Cross Blue Shield of Florida, so I won’t. Huh. Must be one of those non-profit Blue Crosses…😃 ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [December 31, 2009, 4:26am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/252 "2009-12-31T04:26:16Z")
Well, as it happens… it is. :mad: ---
**Author:** ![spinky](https://avatars.discourse-cdn.com/v4/letter/s/59ef9b/32.png) [@spinky](https://boards.straightdope.com/u/spinky)\ **Post date:** [December 31, 2009, 4:30am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/253 "2009-12-31T04:30:29Z")
> [@curlcoat](#): > > Which example is that? You have insurance. If you didn’t actually intend to talk shit about “every example here” without qualifying it as “every example here of people without insurance,” then you should be more careful. Maybe this type of imprecise maligning of large groups of people is the reason everyone thinks you’re a fucking asshole. ---
**Author:** ![spinky](https://avatars.discourse-cdn.com/v4/letter/s/59ef9b/32.png) [@spinky](https://boards.straightdope.com/u/spinky)\ **Post date:** [December 31, 2009, 4:33am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/254 "2009-12-31T04:33:17Z")
> [@kaylasdad99](#): > > Why is it your problem to have the claim resubmitted to the correct insurance company, instead of the hospital’s? > > Be simpler to have the ins. co. that paid the claim to go after the ins. co. that _should have_ paid it. Sure, that would make a lot of sense. The person at UHC who I spoke with didn’t seem to think this is the way it should work, and in fact told me that the way it’s going to work is they’re going to get the hospital to give the money back to them, and then the hospital needs to resubmit the claim to the correct insurance company. Experience tells me that if I just cross my fingers and hope that happens, I’ll get the shaft, so I’m going to need to follow up on this and make sure it gets submitted correctly. ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [December 31, 2009, 4:41am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/255 "2009-12-31T04:41:13Z")
> [@ntucker](#): > > If you didn’t actually intend to talk shit about “every example here” without qualifying it as “every example here of people without insurance,” then you should be more careful. Maybe this type of imprecise maligning of large groups of people is the reason everyone thinks you’re a fucking asshole. I’m sorry you are unable to follow a sentence, but that is certainly not my problem. My response was to **vivalostwages** , who said “How do you know that all of the working poor are choosing to buy things other than insurance? How do you know that their income allows them to buy anything beyond rent, utilities, phone, and clothes?”. If you didn’t understand that my response was concerning people without insurance, there is nothing I can do about that. I suggest _you_ be more careful… 😛 BTW, not everyone thinks I’m a fucking asshole. There are quite a few folks even in here that agree with me, but they aren’t willing to put up with the bullshit you all fling at them. Simply because this board has a majority bent doesn’t mean that _everyone_ is in lock step with your beliefs. ---
**Author:** ![sinjin](https://avatars.discourse-cdn.com/v4/letter/s/ebca7d/32.png) [@sinjin](https://boards.straightdope.com/u/sinjin)\ **Post date:** [December 31, 2009, 4:54am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/256 "2009-12-31T04:54:14Z")
> [@curlcoat](#): > > BTW, not everyone thinks I’m a fucking asshole. FTR I do think you are a fucking asshole. ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [December 31, 2009, 5:09am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/257 "2009-12-31T05:09:36Z")
> [@sinjin](#): > > FTR I do think you are a fucking asshole. I haven’t noticed you before, but based on this post I’d say you probably have the brains God gave goldfish. Which is better? 😃 ---
**Author:** ![The\_Lurker\_Above](https://avatars.discourse-cdn.com/v4/letter/t/dc4da7/32.png) [@The\_Lurker\_Above](https://boards.straightdope.com/u/The_Lurker_Above)\ **Post date:** [December 31, 2009, 5:24am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/258 "2009-12-31T05:24:11Z")
> [@curlcoat](#): > > BTW, not everyone thinks I’m a fucking asshole. There are quite a few folks even in here that agree with me, but they aren’t willing to put up with the bullshit you all fling at them. Simply because this board has a majority bent doesn’t mean that _everyone_ is in lock step with your beliefs. Why do I have this song [http://barb.velvet.com/humor/lurkers.html](http://barb.velvet.com/humor/lurkers.html) stuck in my head all of a sudden? ---
**Author:** ![spinky](https://avatars.discourse-cdn.com/v4/letter/s/59ef9b/32.png) [@spinky](https://boards.straightdope.com/u/spinky)\ **Post date:** [December 31, 2009, 6:01am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/259 "2009-12-31T06:01:31Z")
> [@curlcoat](#): > > If you didn’t understand that my response was concerning people without insurance, there is nothing I can do about that. Well, you’re a moron if you think it was possible to know that from what you wrote. > [@](#): > > BTW, not everyone thinks I’m a fucking asshole. There are quite a few folks even in here that agree with me Look, I don’t give a shit about agreeing with your politics. You’re a fucking asshole, and I bet there are plenty of people who agree with you politically that would say the same. Just to be clear, the fact that you disagree with so many here is not the reason they think you’re an asshole. It’s that you disagree like an asshole. ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [December 31, 2009, 6:15am UTC](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612/260 "2009-12-31T06:15:04Z")
Quite right! You would do well to learn by example. When I disagree with a shit-for-brains like **ntucker** , I couch in friendly and gentle terms, so the leprous little twit isn’t insulted. [Previous page](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612.md?page=12) [Next page](https://boards.straightdope.com/t/health-care-horror-story-13848732/522612.md?page=14)