Wednesday, August 26, 2009

Dealing With Insurance and Billing Update

I posted about my issues with my insurance company not wanting to cover the genetic testing we had to do for our family a long time ago. I also explained how I had to call numerous times and try to figure out what was happening. Our entire family had to be tested for the ATP7B gene mutation due to my daughter having Wilson's Disease. This was done in April of last year. It has now been over a year and we still have not resolved our billing issues with the laboratory. The insurance company pointed their fingers at the billing department at the lab, and the lab pointed their fingers at the insurance company.

The biggest piece of advice I can give you is this: MAKE SURE TO ALWAYS CHECK YOUR INSURANCE CLAIM STATEMENTS!!!! Don't take it for granted that things will be taken care of on their own. I have learned so much in these past few months and one thing I wish I could have changed is that I had paid attention to the statements that came in the mail.... and read the fine print. You are given a limited time to take care of the amount due before you have no recourse to appeal it. Our insurance company gives us 90 days. Believe me, it sounds like a long time, but it isn't.

What do you need to look out for? Make sure that the information is correct. For example, did you REALLY go to Dr. Smith on July 18th and have laboratory work done? Also, do the amounts charged make sense? If the amounts processed seem outrageous you should definitely check. That is what happened in my case. I saw the amount the testing cost and since I worked in a lab I knew that it looked like too much. Of course, I had NO idea how much I was overbilled. Two days ago, I found out that my testing should have cost me $450 PER person total (who knows how much they REALLY charged the hospital). They were trying to bill me for between $10,000 and $13,000 PER person!! I knew that typically hospitals will charge a bit more to the patients to make up for the ones who don't pay. However, this was definitely a case where there was a billing error. I was able to finally reach someone who could tell me how much the testing was supposed to cost me. I was so relieved to finally have an answer! The biggest issue I had was that they were sending my bills to collections and it would potentially harm my good credit. That was definitely my motivation through all of this.

I am not quite ready to exhale, but at least I don't feel like I have a ton of bricks on my shoulders at the moment. I have to share one little tidbit with you all. I want to share what happened and hopefully inspire you to listen to that inner voice that we all tend to ignore at times. This is what happened: I was in the shower and all of a sudden I had the thought, "why don't you call the lab and see if someone can give you the amount that the test cost and how much you should have been billed for each test?" The funny part about that is that I tried numerous times to find out that very thing but was always unsuccessful. Perhaps it was the way I asked the person or maybe it was the person I spoke with. I will never know. However, as soon as I could I called the laboratory that drew the blood (not the ones who actually performed it since they had already told me they couldn't tell me since I wasn't their "client") and asked if there was anyone who could tell me how much a certain laboratory test that my doctor ordered would cost me. I was transferred to the supervisor and she actually called the Mayo Clinic and found out the exact amount the test was supposed to cost. It literally took only five minutes!!! She then told me that I had called the right person and not to worry. The first thing she would do was to get all my bills out of collections. She would then notify the right people and get my bill corrected. I was so relieved! It was definitely an answer to my prayers.

I think we are all blessed with this inner voice inside of us. We just need to listen to it. Sometimes it comes in a whisper. Other times it might come as an email from a dear friend. You just never know how your prayers are answered. Don't be discouraged. Sometimes things take longer than we would like. However, if we are patient and persevere good things do come. It's definitely true what they say, "Good things come to those who wait."
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I've recently learned that the insurance
company is not always the guilty ones
when it comes to billing problems.
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