Friday, February 27, 2009

While I'm on my soapbox...

I figure that while I am bashing the medical profession, I would add in the Insurance industry as well. When Steve changed his employment status, we had to find our own insurrance. In changing insurrance, I had to send a letter from our old insurrance to our new insurrance saying that we have had insurrance. That way, our new insurrance would cover us and not give us the pre-existing condition run around.

In the process of faxing a bunch of medical records, and application stuff to the new insurrance, I sent that letter, only somehow it didn't end up with all our stuff. So when the first claim came through, they refused to pay it because we hadn't sent that letter. So the first I hear about it is when I get a bill from the doctor's office for around $900! With a nice little hand written note from the billing lady saying that our insurrance won't pay anything until we submit proof of previous insurrance. Followed by her phone number and how and when to reach her if I had any questions.

So, I called up the insurrance lady and tell her that I sent it once and was she sure that she didn't have it. She didn't, so I gladly sent it over again. Then I called the nice lady at the billing department of the doctor's office and asked her to resubmit the claim. In turn, about five days later in the mail, I get a note from the insurrance, detailing what was billed, how much the insurrance was obligated to pay, and what was our portion.

I am using actual number here: The billed charges totalled $882. The elligible charges that the plan paid, were $367. And we were obligated to pay our $25 copay. So I called up the nice billing lady again to make sure that we were OK and didn't owe any more and she said nope, that's it, we're good.

So my gripe here is why would the Doctor's office bill us nearly $900 and not accept one penny less, yet they smile and say "That's great!" to the insurance paying only $367. Less than half what they charged us? That my friends is obsurd. I'm just sayin'.


Judy said...

Insurance kills me too. When I had Sam, I had to deliver out of network because of Sam's issues. Michael called up to ask about something and they wouldn't speak AT ALL to him about it because of "privacy" issues. He said "you mean to tell me I'm completely financially responsible for this, but you can't tell me what I'm paying for." And they basically said yes.
And another example: I'm STILL battling with the insurance and the hospital from when Katelyn was in the ER in Hawaii... 6 months ago!

Lhone said...

I KNOW!!!!!! Don't get me started! I'm battling 4 grand in bills for my surgery. I'm only supposed to have a maximum of 2,000. How does that work? I hate how they charge an arm and a leg for the original bill, and then give the insurance people a break. I don't get it. so dumb. I hate dealing with doctors and bills, and the whole bit. That was like when we had Brittany and finally got to hold her after they got her stabilized, and they called AT THAT INSTANT to tell me how much I owed them. Seriously people? Here's your baby, here's your bill?

Heather said...

Insurance companies make me sick. They make you pay so much to have insurance, and then a lot of them fight you on every claim, and you end paying a ton more. Sometimes don't you just wonder "What's the point?" I know I do.

Megan B said...

I am glad you are going through it first...I am sure that is where we are headed with our own insurance and all...I will have to get your knowledgeable advice on how to get "LESS" messed up (I wanted to say "screwed" but am trying to be better) by the insurance companies!!