On two prior occasions we have received afterthought bills from the hospital, although it has been several months since the last occurrence. Each one makes me a little more upset. I mean, the grocery store doesn't send me a bill after the fact stating that my milk actually cost more than they had originally charged.
So, I got on the speaking telegraph and rang the number printed on the statement - the one that said, "For any questions, call...". This is where our story begins.
Call #1 - "Tom" at the phone number listed on the bill tells me that the service is not covered by our insurance company. "What service?" I ask, "Delivering babies?" Tom explains that the service provided was routine, which is part of preventive care, which is not covered. Tom suggests I take up the issue with my insurance company. I say, "My kid is 14 months old. When can I expect to stop receiving bills?" Tom reveals that the charge is in fact not for Karsten's birth, but for Sara's annual girlie doctor visit - from more than a year ago.
Why am I just now seeing this bill? No - that's beside the point. Why is the hospital billing me for services provided by a different legal entity? Why has Sara's doctor failed, yet again, to submit the proper procedure code to my insurance company? Both good questions. I suggest that the wrong procedure code may have been used. Tom transfers me to our Account Representative, "Tasha".
Call #2 - After explaining everything again to Tasha, she recommends I call the doctor's group practice. She can't change the billing code herself.
Call #3 - I broke ranks here and called my insurance company in order to gather facts and build my case. Low and behold, I was right. The doctor used the improper procedure code. This is not the first time we've had this problem.
Call #4 - Group practice. The receptionist tells me that Sara's doctor is no longer with that practice. She has ventured out on her own. In any case, I'll need to speak with "billing" and she transfers me to option #3.
Call #5 - Billing is gone for the day. It's 3 PM. Why was I transferred there? I back out of the voicemail menu and speak with a nurse at option #4. The nurse confirms that I'll need to speak with the people at option #3. Tomorrow.
Call #6 - Starting over, I explain the situation to billing. She can't find my wife's file. I provide Sara's social security number. Nope. Date of birth - nuh-uh. "Let me transfer you to Judy. She handles these things." I apologize for being crass.
Call #7 - Same as Call #6, but with some additional questions: "Did you two just recently get married?" - thinking perhaps they might have Sara listed under a different surname. Judy then asked for the date of service. "Oh, I think [the doctor] had left the practice by that time. We don't have any records for you after January [of 2008]. You need to call her new practice at..."
Call #8 - New practice reception. "Hi. My wife is a patient of Dr. X. I'm trying to resolve a billing issue." I'm transferred to "billing".
Call #9 - "Hi. Is this the billing department?" I ask. "Yes it is." "Finally! My wife is a patient of Dr. X from her previous office..." I begin. "One moment." I'm transferred into the matrix.
Call #10 - "Hello. You have reached Bonnie in billing. I am unable..." I leave a detailed message.
Call #11 - Bonnie calls me back. We start at the beginning. She cannot locate any information about any patient prior to April [of 2008]. She says she will talk to Dr. X and call me back before the day is out.
Call #12 - Bonnie calls me back again. Dr. X said she can't help me. I'll have to call her old group practice. I've had it.
Call #13 - LAST CALL. I call Tom back using the phone number on the bill. He once again tells me that the service is not covered by my insurance policy. I suggest to Tom that he may be mistaken. I tell him I have confirmed with my insurer that the service is indeed covered. I explain that the improper procedure code was submitted by Dr. X. I tell Tom that I have spoken not only with him, the account rep, and my insurer, but also with numerous representatives from both Dr. X's old and new practices. Nobody knows anything about the charge except for Tom and Tasha. Sara's appointment has apparently disappeared within a blip in the space-time continuum. As such, I tell Tom, regardless of the procedure code, I shouldn't have to pay for services that never occurred in the history of all time. Tom tells me to disregard the bill. He and the account rep will attempt to get the procedure code corrected and resubmitted to my insurance company.
The peasants rejoice.
4 comments:
You need a "rate it" option for "exasperating". That is totally ridiculous. We are going the rounds with our insurance company, too. They keep sending us a "final" adjustment bill. If it's final, why do they keep adjusting the amount and asking for more money???
I hope you mean my experience was exasperating - not my recounting of it. I love our insurance company. It's Sara's OCD-stricken girlie doctor I can't stand.
Why is it that this always happens? I have to contact every doctors office we've ever been to just to resolve simple billings. We were billed for not only this (what sounds like) the exact same thing more than a year later, but also when Jon had a bad ankle sprain (while at work) we received numerous letters from workers comp and the hospital saying the account was paid in full, then we get a another statement 19 months later saying we owe X amount of dollars... it took me 2 weeks to get them to believe that not only was this workers comp, but that it had already been paid. ??? I think they are just out to get the suckers so they can get more money. I know plenty of people that will just pay the bill so it will go away!!
@Julie - You just reminded me of another issue I need to deal with from our pediatrician.
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