Friday, September 21, 2007

Mediating Between Insurance and Doctors

I've spent around 6 hours now over the last two days trying to sort out the mess that my insurance company and doctor's office has going on. Yesterday I received a bill for over $200 from my doctor's office. Now you have to understand that with my insurance and the fact I pay all of my co-pays the day of the visit, I should NEVER receive a bill from my doctor.

Anyway, so I go to my insurance website to look at all my EOBs and find out what is going on. Well, one of them was denied, usually coded wrong, will contact insurance to find out denial reason then inform the doctor. One it appears the insurance mishandled, will have to call them on that one. Oh and this one is just weird, it looks like insurance paid but not all of it, this one will be interesting. Oh dealing with them both... what fun.

So last night I call the insurance company. The one was denied because it was coded as administrative, needs to be recoded. Just as I expected. The second one did confuse him but it was obvious someone on their side had messed up, so he is sending it for review. That was really all I could deal with on the insurance side.

Now for the doctor. Well for the first one they have to check to see if it's ok for them to rebill it the proper way. Um, it was a physical, bill as such. The second one didn't really apply to them but I let them know it had gone in for review. The third... yes the third. Well apparently they still believe that there was only $93 paid of the $123 that should have. Despite my insurance company showing they paid it all. So after talking with them for over an hour over this, they finally agree to send it to their rep to find out what is going on. So this couldn't have been done sooner rather than keep me on the phone repeating the same thing?

Anyway, so now my bill is still in limbo and I just have to hope the two of them get their heads together. Some days I think it would be easier to set up a conference call between the two and let them discuss it out. Gotta love em!!!

1 comment:

  1. OMG Amy thats nuts!!! I feel for ya girl!!! I hope they get it all worked out soon!! Later, Amie