Rant Ahead: Health Insurance Giving Me Grief

Miscellaneous and Personal Stuff I Must Share
1

Okay, so back in July of last year I had an issue with my nose, recorded for posterity here. I had to have a bit of minor surgery to remove it, but all has been well in the nasal regions since then.

But that doesn’t mean I’m not still paying for it. Oh, how I’m paying for it.

It started out as a routine bill received in the mail from my health insurance provider (which will remain nameless until this fiasco is sorted out). I owed in the ballpark area of $650 for the procedure after all is said and done. No problem. Charge it to my credit card, away we go. Bill taken care of, correct?

Wrong.

Next month, I get another bill from them saying that I still owe them around $550. At first I was like, okay, but after me and my dad reviewed the bill we realized something. They were billing us for the exact same procedure, again. Same procedure codes, same everything: aside from removing one of the two charges (the $100 one, of course) it was the same bill as the first one. Of course, my credit card bill showed a $650 charge to it. So where’d that extra money go?

So on my day off I call up the financial services and ask them what’s going on with my bill. I clearly point out that I’m being billed again for a procedure that I thought I had already paid for. After a whole lot of runaround and being on hold, the person I am talking to informs me that the bill is in fact correct, I still owed $550, and that the rest of the $650 that I already paid went to co-pay and other extra things that didn’t show up on my bill but I still had to pay for.

What.

After politely asking why I am paying for things I don’t even know about, she politely informed me that if I wanted I could request a detailed bill that showed all the charges I needed to pay for. But first I’d have to fill out a bunch of forms and send them in.

Now, this doesn’t make any sense to me. Why do I need to fill out forms to find out what I’m paying for? Shouldn’t everything, you know, be on the bill in the first place?! At this point, my dad and I both agree she’s just trying to get rid of me. So I turn the conversation over to my father, who is a bit of a heavyweight in dealing with financial things and knows his way around money.

After a bit more talking on his part, we’ve filed an official complaint so the lady is putting my account on hold and she’s going to flag my account and have it looked at thoroughly to see what’s going on, and to call back next week. Okay, that’s cool.

I call back the next week, and the person I talk to says that regional is still looking over my account and it will take two-to-three weeks to sort it out. Okay, that’s fine too.

Which brings me to today.

Now, first of all, since the last time I called in I’ve received a new bill. This bill now has me owing a little less than $200 as somehow an extra $300 payment has been added to my bill. Of course, I haven’t paid anything since the $650, so where did this new $300 come from?

The guy I talk to this time looks at my account, and tells me that regional’s reviewed the account and my bill is correct. At this point I just hand it over to my dad who has way more experience dealing with this stuff than me and I just listen and learn. The guy gives us the same run-around as the original lady, that there are hidden fees I didn’t know I was paying for that I had to pay for. Well, where’d the $300 come from? I dunno, is his reply. Why are we being charged twice for the same procedure, then? His response: there are two companies that I have to pay and they both charge the exact same. What?

This is just getting more and more off the wall. No matter what we try to point out, it comes back to “if you want a more detailed report, you’ll have to fill out some forms and request it.” But unfortunately I can only put an account on hold once per complaint, so he can’t put my account on hold any more.

So now I have to wait 3-4 business days for them to mail me the forms I need to complete, which I will then have to fax back into them, and then wait another 3-4 business days (and change, I’m assuming, for them to process the forms) for them to send me the “detailed” bill. All just so I can see, you know, what I’m supposed to be paying for. And of course, the latest bill is due in two weeks, but they can’t put my account on hold for any of this. Oh no.

Ugh. This has put me in a sour mood. :mad:

2

This isn’t necessarily insurance related. I had to go to the hospital in June of last year and when I got there I gave them my insurance card. They billed my insurance properly and my insurance company paid their portion exactly the way they were supposed to with no problem. Then they started sending me bills. I got a bill every 2 weeks for over 4 months for various amounts. Sometimes it was $12 towards a doctor’s bill that had been partially paid for by my insurance. Sometimes it was a $35 bill for other things that were clearly labeled. Then I got a $548 bill out of nowhere that just said it was for services rendered. It took 5 phone calls over a 3 week period to get them to send me an itemized bill to tell me it was for an x-ray I’d had done. At that point I paid the bill with no question because I knew what it was for (finally!) but that didn’t stop them from turning me over to a collection agency after I’d paid them. :rolleyes:

3

This is one of the reasons I continue to go without health insurance. I’m pretty well convinced that it will be less trouble to have to pay for something after the fact if I ever need care.

Say I get billed for a gazillion dollars after undergoing an emergency gesplogial transplant. If I were insured, they’d try their best to weasel out of it, I’d be stuck with an insane bill, declare bankruptcy, etc.

If I’m uninsured, I still declare bankruptcy. But at least I don’t have to deal with weasely insurance companies.

4

That is totally your choice and you are welcome to make it, but health insurance could be the difference between declaring bankruptcy and being homeless. It could also be the difference between receiving treatment right away or being forced to go to another hospital and wait in line for 16 hours before a doctor might even be willing to see you. Keep that in mind when you are thinking it is worth it to avoid the hassle of the billing.

5

You know, insurance does pay for a lot of stuff, without any problems. You’re taking a pretty big risk here.

Just to show the other side of the coin, I’ve got crappy self-employed insurance. Was perfectly healthy up until last November when BAM! out of the blue, I find out I’m diabetic.

Insurance hasn’t denied a thing yet, and I haven’t had to complain even once. Bills are into the several thousand dollar range at this point.

Now, I haven’t actually hit my deductible yet, but that’s another story. The important part: nothing has been denied.

6

I’ll bet you have Blue Cross/Blue Shield insurance. We used to get bills for 13 cents because they only covered 95 percent of the lab fees and the lab fee was 2.50 or something…honestly it cost them more to mail us the 5 page statement saying we owed them 13 cents then it did to just pay the 13 cents.

And oh, the deluge of paperwork “Explanation of Benefits” that woudl come after every doctor visit…often 2 or 3 mailings, each 4 or 5 pages.

I’m so glad I have CIGNA now.

7

You should compare your bill to your explanation of benefits from the insurance company. Also, if you have two different doctors billing you for that surgery (which is possible, i.e, an anesthesiologist and a surgeon), your insurance company should have two separate claims on file. I don’t pay any doctor bills until I’m sure the claim has been processed correctly by my insurer.