I spend hours on the phone each week fighting with people in order to coordinate and pay for my care. By "people" I mean the poor souls who have the answer the customer line at my insurance company, and my doctors' offices, and the place that takes my blood, and the hospital, and the testing facility...the list goes on. And by "fighting", I mean that I'm too nice, so I really spend hours on the phone each week politely explaining my case to try to make people care about my plight and then do their jobs.
Sometimes my problem is resolved with a phone call. However, usually it drags on and on--multiple long calls are needed, sometimes letters need to be drafted and sent, I even have made personal visits to billing offices to clear up issues (I'm sure they loved that). I noticed that the reason my problems take months to be solved is that they get passed from office to office. No one wants to deal with a problem, especially when I might just give up and pay them. This summer, I had a few x-rays done of my neck by order of one of my physicians. I got the x-rays at the same hospitals where that physician practices. Both the hospitals and the physician were covered by my insurance; however, my insurance refused payment because my "preventative schedule" did not cover the x-rays. I discovered (after calls to my insurance) that the x-rays should have been billed at diagnostic, not preventative. Somewhere along the way, the billing code was incorrectly changed. After approximately 3 dozen calls to the various parties, I still don't know how the mistake was made or who made it, but it was mysteriously fixed and my insurance paid.
I think billing and insurance issues happens to those with chronic illnesses on a regular basis. Mainly because we require more care, but I also sometimes wonder if a handful of others try to take advantage of us. I believe there is always that chance when an ill or disadvantaged individual is involved. My advice to you is to always double check you EOBs and bills: do they match? Also, actually read your EOBs and check the codes at the bottom. Is your insurance covering all that it should be covering? If there is an odd code, don't hesitate to call your insurance to ask about it. Also, find out if your doctor can re-write a prescription/order so that it can be covered. If you are having a problem with your doctor's office, speak to the billing department, and don't be afraid to ask for the office manager.
Sometimes my problem is resolved with a phone call. However, usually it drags on and on--multiple long calls are needed, sometimes letters need to be drafted and sent, I even have made personal visits to billing offices to clear up issues (I'm sure they loved that). I noticed that the reason my problems take months to be solved is that they get passed from office to office. No one wants to deal with a problem, especially when I might just give up and pay them. This summer, I had a few x-rays done of my neck by order of one of my physicians. I got the x-rays at the same hospitals where that physician practices. Both the hospitals and the physician were covered by my insurance; however, my insurance refused payment because my "preventative schedule" did not cover the x-rays. I discovered (after calls to my insurance) that the x-rays should have been billed at diagnostic, not preventative. Somewhere along the way, the billing code was incorrectly changed. After approximately 3 dozen calls to the various parties, I still don't know how the mistake was made or who made it, but it was mysteriously fixed and my insurance paid.
I think billing and insurance issues happens to those with chronic illnesses on a regular basis. Mainly because we require more care, but I also sometimes wonder if a handful of others try to take advantage of us. I believe there is always that chance when an ill or disadvantaged individual is involved. My advice to you is to always double check you EOBs and bills: do they match? Also, actually read your EOBs and check the codes at the bottom. Is your insurance covering all that it should be covering? If there is an odd code, don't hesitate to call your insurance to ask about it. Also, find out if your doctor can re-write a prescription/order so that it can be covered. If you are having a problem with your doctor's office, speak to the billing department, and don't be afraid to ask for the office manager.
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