I’ve just gotten off the phone, after thirty minutes, wih our health insurance company. It seems that they, for some strange reason, have been filing all of our most recent claims as “out-of-network” instead of “in-network”. So, instead of charging us 10% for each visit to the doctor, they have been charging us 40%!
Spending thirty minutes on the phone with an insurance company is never pleasant, but, I did manage to find a very competent representative and she quickly explained that the mistake was on “their end” and not “mine”. Taking the time to review several Explanation Of Benefits from my insurance company and several bills from our doctors proved to be beneficial – to the tune of saving $208.34.
Remember, if you receive a bill for a service, and you don’t understand it, make a phone call. Do not give up until you find someone who can and will thouroughly explain each and every charge. Before I hung up the phone, we went through every single claim from 2008, just to make sure that this had not happened earlier in the year. Thankfully, there were only problems associated with bills submitted in the past two months.
I have already put it on my calendar to call back in a month, just to check in with them. Hopefully, all issues will have been corrected.
You would be surprised how many times this happens. Drs and hospitals file claims electronically with TIN (Tax ID Numbers) and most of these providers have more then 1 TIN. If someone in billing submits with the wrong TIN the claims computer processes it as out of network. Unfortunately I deal with this all day long being an insurance agent. When in doubt call your agent or insurance carrier. Many people just pay the bill. Then complain that their insurance does not pay anything!
You really have to keep the medical/insurance industry honest. Not necessarily because there are evil folks out there to get you, but because of the endless rules, account codes, etc. that they must contend with. Most mistakes are honest mistakes, but it still costs you nevertheless!
I had a similar experience with my health care company for a hospital visit. They were charing out of network rates despite it being an in network hospital. If I hadn;t checked, it would have cost me an extra $700….so it pays to always check your charges.
I had a similar situation with my insurance. My wife went to the ER two times within a week of each other for the exact same medical issue. Both visits she received the exact same treatment. Weeks later we get the bill for the first visit. $50, per our insurance requirements. A week later we get the second statement, $536!!
I spent quite a bit of time on the phone with the insurance company and the hospital over the next few months. Turned out the hospital coded the first visit as an Emergency Room visit, but the second as an Outpatient Doctor visit, which wasn’t covered somehow.
It took a long time to work it out, but about three weeks ago I finally got a statement from the hospital saying I owed them $50 for the visit. They had gotten everything straight at last.
Just goes to show, you really do have to be persistent with these health care industry people, iInsurance companies or hospitals, for however long it takes.
That should be a lesson for everyone that reads this; going through bills can seem tedious but it pays off if you find out errors like this one. Not just for medical bills too! I have read so many blogs that give money-saving tips and one always seems to be: look over your monthly statements and always watch the register when buying things and just always taking the precaution to avoid any situations where you end up paying more money for someone elses carelessness. Then again, it becomes your carelessness too if you’re not checking everything.
Isn’t this routine for everyone these days? I swear most of the time I go to the doctor the billing gets messed up somehow. I about had a heart attack one time when I got a $700 bill for a pre-authorized doctors visit. It took months to correct, all over some billing code error which, you guessed it, showed the doctor as “not in network”. Also the insurance statements seem designed to confuse, I am never quite sure if I still owe money.
Good you caught it, $200 is a good chunk of change.
Insurance is almost always a hassle. You’re one of the lucky ones to have caught the mistake they made, wonder if they made the same one to others, and if they caught it?
30 minutes is quitea while, but you can look at it this way $416 dollars an hour!