health insurance dammit

[boxofdelights]

I'm not going to put a 'politics' label on this, because this exact thing has been happening to me for 30 years, and I don't expect it to stop in my lifetime. This thing is: I have health insurance. I see a health care provider. I hand over my insurance card and my payment. A month later I get a bill from the health care provider. I call the health care provider. I talk to a phone-answerer; she doesn't know anything about anything, except that her screen says I still owe $X. I confirm that they have my insurance information, that they billed my insurance, that the services they billed were the services I received, which are covered by my insurance. I call the insurance company. They assure me that the health care provider's bill has been paid in full, and that I do not owe them any more money. I call the health care provider back. The phone-answerer says they'll look into it. Thirty days later I get another bill for the same charge, in pink, with threats to send it to a collections agency. Most often, another round of phone calls will settle it, though the health care provider never admits that they got anything wrong; they promise again to look into it, and this time I don't get another bill.

I'm so angry right now. I hate the phone and I hate arguing with people and my blood pressure reacts very very badly to threats, and there's nothing I can do except stew about it until tomorrow, because I picked up the mail when I came back in from walking the dog, which was just after 5:00.

I wonder how many people who are more phone-averse or less good with paperwork or just too damn busy or not as entitled to fairness as I think I am just cough up the double payment.

I wonder whether these things would happen to me so often if I had changed my name when I got married. They don't seem to happen to my non-Hispanic husband.

Comments

[cereta]

Yeah, that is not on. I am really sorry that you're having to deal with this, and furious on your behalf.

I have had a couple of providers try to bill me for the amount that the insurance company "adjusted" the bill to. Every time, the insurance company assures me that I am not responsible for that amount. I've been very lucky that the providers have backed down on a second round of phone calls when I tell them what my insurance company has said, but I can imagine a great many people just automatically pay any bill sent to them. It makes me furious.

[bibliofile]

Argh.

[sonia]

I wonder whether these things would happen to me so often if I had changed my name when I got married. They don't seem to happen to my non-Hispanic husband.

... wow. There's garden variety medical billing grossness, and then there's racist medical billing grossness. UGH!!!

I wish there were someone to escalate the problem to who could solve it once and for all. I'm also furious on your behalf.

So far I've had two appointments at Kaiser that were preventive care, i.e. no copay, and they've tried to charge me the copay both times. I also wonder what people do who don't have the time and energy to wait on hold and assert themselves. UGH.

[loligo]

Does he go to the same clinic and use the same insurance? Because I just started working on an employee retention project at work, and WOW the turnover in our billing department is terrible. The work is tedious and complicated, and a significant number of the people doing it have been there less than 3 months…

(And yes, I share your hate & frustration for the insurance dance…)

[jesse_the_k]

What a total waste of your time (not to mention the time of everyone in the billing interaction). This sort of nonsense is another reason why admin costs for universal healthcare are dramatically lower.

[siderea]

What may be happening – this is excuses nothing, mind you – is that:

1) The provider bills the insurance.
2) [Elapsed time]
3) The insurance approves the charge.
4) [Elapsed time]
5) The provider, having still not recevied any money, bills you.
6) [Elapsed time]
7) You get the bill, call the provider. "We haven't been paid. You owe us." You call the insurance, "We've totally approved that, and are paying it." Both these statements are true.
8) [Elapsed time]
9) [Elapsed time]
10) The insurance company actually sends money to the provider; not just for your services, but for all the patients under that insurance served in one month by that provider. [Maybe 3-5 days EFT? Or maybe is still mailing a check?]
11) The provider's bookkeeper needs to reconcile the lump of money and associated list of services paid for with their own computer system.
12) Provider's computer now indicates your services are paid for.

Personally, I wouldn't even begin to consider paying a bill for healthcare until 90 days after I'm billed, unless I already knew my insurance wasn't paying for it.

[silveradept]

Arrrgh. What frustration that must be.