Yesterday I received a statement from the insurance company saying that we will be getting a bill shortly for some recent lab work, to the tune of $500!!!!
I am so furious. I was told it would be free! Our insurance is suppose to give free lab work, and our doctor personally suggested that place because it was supposed to be covered.
Before we had the tests I even asked the receptionist if we were in network and she said yes. She took our credit card, and said, "well it looks like your insurance covers everything but $35."
I thought that was odd, considering it was supposedly free, but I thought maybe we would just get reimbursed or something. Or it was a co-pay.
Well it turns out... yeah they take our insurance, but they are counted as "out-of-network", which is basically the same thing as not being covered!
Sure enough, I did some digging online. And it lists our healthcare as covered. Then at the very bottom is tiny fine print, it says, "will be counted as out-of-network."
What a bowl full of poo. Apparently this is a common problem with the company, and there is a lot of lawsuits against them.
What do I do? When I receive the actual bill I will be calling the company and giving them a piece of my mind. But how in the heck am I supposed to prove that they told me it was covered? Should I just pay it?
Gah!
SO MAD!!
November 19th, 2014 at 03:32 pm
November 19th, 2014 at 03:35 pm 1416411347
I share your sense of fury.
Do you have an HSA? Then you would be paying them with tax free money.
November 19th, 2014 at 04:53 pm 1416416006
November 19th, 2014 at 05:37 pm 1416418659
November 19th, 2014 at 05:44 pm 1416419070
November 20th, 2014 at 12:09 am 1416442181
If they say no, there's nothing we can do, keep persisting and escalate it. Ask to talk to a supervisor. If they still say no, ask them to explain the process of disputing a claim and if you have to, put your thoughts and what happened all down in writing. It may be that, given this has happened before and they are taking heat for it, they may relent on your particular situation. You won't know til you try.
The whole health insurance payment system is not at all transparent. Not only do patients not know exactly what they are paying for a given service, they do not know how many individual health care providers are involved in their healthcare, or who will be billing them for services (like your anesthesiologist).
November 20th, 2014 at 01:18 am 1416446281
Because as you say, as a patient, you aren't going to interrogate every medical person that touches you. When I gave birth, my anesthesiologist was a 'hidden provider' and charged me full price. When I called them and used that terminology and said "You can't do that.", they corrected the bill.
November 20th, 2014 at 02:19 am 1416449943