Friday, June 8, 2012

The Run-Around

When we had Eli, with all of his medical needs and time in the NICU, I expected a rather large medical bill - and that was delivered to us.  But, I admit to being very surprised when medical bills for this, rather straightforward and easy birth started coming in.  With this delivery, our problem seemed to be with my 3 triage visits (sent by my doctor) for monitoring.  One such visit was completely denied by our insurance company and the other two had high enough co-pays attached to them (and some denied services) that they might as well have been denied!  The whole thing was frustrating and didn't make sense to me, so I figured one simple call to the insurance company would clear this up!

Boy was I wrong!  I spent about 30 minutes on the phone with our insurance company, which to add complication to the whole matter, Peter's company switched insurance companies as of June 1st so this is his old insurance company now.  All was calm in our home when I started the call, until some door to door salesman, ignored our sign on our door that says NO SOLICITING and rang the bell anyway.  This made the dog bark, which made two of my children start to cry and woke up the sleeping child, all while I was dealing with a very confused insurance lady on the phone.  I was not a happy camper to say the least!  Once this call was ended, our insurance lady said that they would try to fix the high co-pays and that I needed to call the hospital to clear up the denied claims because they needed a different billing code.  Sounded simple enough, or maybe not!

Start with a simple call the hospital where the bills are coming from.  They said we need to deal with my doctor's office to get the code changed and then it will come back through the hospital.  Alright then.  At my appointment this week I asked to speak to billing.  In addition to our insurance changing as of June 1st, I should also mention that as of the end of May my doctor has now changed locations.  Her office, which used to be located inside the hospital moved outside the hospital.  Apparently they do not handle their own billing now so they gave me a phone number of the person who does.  I call that number, they input all my information and tell me that they can't locate any bills.  Alright then, because I can assure you that someone is asking for money from me right about now.  They asked if it was an existing  balance - um, yes it would be an existing balance because how else would I know that I owe the money?!?  Well, they are not handling existing balances.  I need to call my doctors old office, which is located in the hospital for help on this claim.

At this point I am about to scream.  Peter tells me he would probably ignore the whole thing if it wasn't THOUSANDS of dollars we are talking about!  I must mention a little bit that I know about the billing lady at my doctors old office.  She is not all that helpful.  She sits right behind the receptionists at the office.  Several times while I would be in the waiting room, someone would call the office to speak to billing.  The receptionist would put the person on hold, lean back and ask the billing lady if she would take the call.  The billing lady would tell them to send them to her voicemail.  The billing lady would then proceed to stand up and walk away from her desk while the receptionist sent the call through.  Well, I believe I was the recipient of such a move from the billing lady yesterday.  I now get to wait for this billing lady to call me back, and it's going on 24 hours over here!

I've been working on this for over a week now.  Our *old* insurance company still has not reduced the copay amounts and I have gotten nowhere with trying to get our denied claims a different billing code.  This is the society we live in.  Maybe I need to move to Canada!

UPDATE:  The billing lady at my old doctor's office called me back this afternoon. Apparently she no longer can access my records.  I tell yeah, this is getting ridiculous.  She was super nice and tried to be helpful.  She said that it really is the hospital's responsibility to try and get a hold of the doctor because they have to work together to fiz the problem.  So she said she would call the hospital billing people and try to get them to talk to my doctor and get it all figured out.  I can hope this is the end of it.

On another note, the hospital billing department called me today with a "courtesy call' asking when I was going to pay my bill.  No, I cannot even make this garbage up.  I told them we would love to pay the balance as soon as our insurance and doctors office got everything straightened out.  He asked me how long that would take and said they would give me another 30 days then.  Seriously?  I JUST had this baby 7 weeks ago and you are heckling me for the money, for a bill that I JUST got last week?!?  Ridiculous, ridiculous, ridiculous!  


Elle J said...

Been there! You would think in the age of technology that it would be "easy" for all medical parties involved to communicate so effortlessly. Seems like the medical community and insurance are still working with paper and pen. Right?! Hang in there - and document everything (person you talked to, date/time, and summary). Just to have the ability to call out a specific name/date/time when you do this round robin talk with everyone involved will keep everyone accountable, and give you tons of credibility. Most people don't but it does make a difference. Best of luck! =)

Rachel said...

This is what is wrong with medical care right now... when we moved to Eugene, we found out that every Dr. in Eugene expects you to make payments during your pregnancy so you won't have a balance due at birth. With our very BAD coverage we have right now, our monthly payment, to have the balance paid off at birth, was going to be $450. AND once we schedule my c-section, I got 2 bills from the hospital to 'make sure my surgery was paid for BEFORE', which they totaled $10,000. Yes, we have HORRIBLE medical coverage. But the point I'm trying to make is, they all suck!!! :) LOL!

Rachel Daniels