posted
Everyone who knows me knows that I am the nicest person they are likely to meet. I have no temper to speak of. It takes a lot to get me mad.
Today I am upset.
In 2001 I had some sinus headaches. I went to my doctor and he wanted to run some tests to make sure they were sinus and not anything more dangerous.
Being fully insured at the time, I agreed and had an MRI.
The MRI was done either late in 2001, or 1/2/02. That is the date on the bills, but I am unsure if that is correct. I would normally remember doing something medical the day after new years. OK, I normally would avoid it.
Last september, 19 months after the MRI (which turned up negative), I recieved a bill for the procedure.
I ignored it, not even opening it till later because I thought it was more Insurance Sales garbage. Besides, they have been known to bill me and my insurance company.
By December 1 I recieved notification that this bill is over due.
I called the insurance company.
My insurance is carried by my company. They traded insurance companies back in May of 2002.
I called the old insurance company.
They informed me that due to financial reasons, during the first part of 2002, the company I worked for was "Self Insuring" its people. In other words, they were paying the bills and I need to contact my home office to get this straigtened out.
I sent an e-mail last week.
Nothing.
I e-mailed again this week.
Home office responds, "Yes we were self insuring ourselves at that time. Just pay the bill and we will reimburse you for everything short of you deductible."
"How much was that deductible?" I asked.
"$1,000"
I had a $1,200+ MRI, and my home office is smiling and saying don't worry, we'll pick up the $200 and change.
Why was I paying hundreds of dollars a month for insurance? Just so I could get a $60 copay on my medication (Allegra)?
I checked the "Summary of Group Benefits" that I had from that time.
It statest there is no deductible for Lab or X-Ray.
I ask my personell manager, isn't an MRI a Lab or X-Ray?
She says, "I don't think so. Why don't you pay it and we'll straighten it out when I get back from vacation next month. Honest, we'll reimburse you whatever we decide is right."
My wife and I made $1000 doing Santa shows and such over the past month. We hoped to put that all towards our adoption expenses instead of taking out a home loan.
Don't pay ANYTHING. You'll never get your money back. Do not pay the bill. Explain what is going on to the medical people, and harass the person who said "We'll pay you what we think is right."
Don't pay it. There's no deductible for lab or x-rays. An MRI should count.
Ela, CT, Theca, the-new-guy-who-seems-to-know-about-medical-matters? What do you think?
Posts: 26077 | Registered: Mar 2000
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posted
I agree with kat. Call the place that's billing you, give them the address of your employer and explain that they need to bill them. Let them duke this nonsense out.
Posts: 32919 | Registered: Mar 2003
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Did the place say WHY it took them 19 months to get around to billing you? (don't you wish there was a statue of limitation on this sort of deal?)'
I had a similar problem once where a doctor wanted to run a heart test on me because of a concern that came up in a general exam. The tests all came out negative. My insurance refused to pay it because they determined it was an "unnecessary procedure". Even though I didn't ask for the procedure, the doctor insisted I get it! I asked them when they would have considered it 'necessary' and they said, "if it had come out positive instead of negative, confirming a problem present, then it would have been covered.." What the hey???? So because I happened to pass a test with a clean bill of health, I get billed for it??
Fight them, fight them. Most places know people won't fight, they will believe whatever the insurance company/employer says as gospel, and that ain't so! Don't pay it!
My company has stated they will NOT pay this bill.
Yes, I was right, the MRI is considered a test/x-ray and as such I have no deductible.
However, since it took them so long to bill me they refuse to pay.
They suggest that I object and not pay either.
I am so glad I didn't take there first suggestion and pay, then wait for reimbursement.
I am now trying to formulate my response. Part of me wants to rip out there hearts and eat them. Part of me wants to appease the office to insure I get well treated in the future.
Part of me is analyzing the anger that is churning inside me, growing like steam in a closed pot, just waiting to explode. The more I think about it and try to get over it, the angrier I become.
Interesting.
I think I need a laugh.
Posts: 11895 | Registered: Apr 2002
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Around here, if a doctor's office doesn't send you a bill within 12 months, you don't have to pay it and neither does your insurance. YMMV
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Private insurance sucks, and it ends up roasting the delicate parts of all innocent parties involved.
Egads, Dan, I'm so sorry. I'll think on it awhile & see if I have anything useful to offer.
(*just to remind y'all, there's a place where you only have to keep track of one number, the physicians don't have to justify claims to private companies, and there are better morbidity and mortality rates than here )
I wish I could fix it, Dan. ((Dan))
Posts: 14017 | Registered: May 2000
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See, it's their responsibility to bill your insurance company if you provide proof of insurance.
They can't bill YOU 19 months after the fact.
I went through the same thing just out of college, when I got a bill for a hospital stay that was never billed to my insurance nor did they send ME the bill until a year and a half later.
They had to just suck that one up.
Posts: 14745 | Registered: Dec 1999
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