Tuesday, October 14, 2008


OH, it's such a love-hate relationship!!!

Normally doctors file with insurance on your behalf. However, there are times when you're on your own. When you deal with many doctors and hospitals and insurance stuff, you get to be a pro. When anyone asks what I do, (aside from being a SAHM) I tell them I am a professional medical patient.

You know those ads for medical transcription and bill coding? I could do it in my sleep. I can read doctor's handwriting. I know the right code for billing. And God help you if you have the wrong code. I'm fighting a bill since MAY that has the wrong billing code. I went to a dietician for diabetic education on cholesterol, which is covered 100% by insurance. The billing code was submitted as nutritional counseling, which is NOT covered by the insurance company, to the tune of $118.00. Same amount of time, same person, same service, WRONG CODE.

So I call the billing department. They can't change it without authorization from the person who put the wrong billing code in the first place (the dietician). So I call him. Yup, no problem he'll change it.

That was the first month.

Second month I get another bill. Called said dietician again. Left a voice mail, AND an e-mail. He forwards my e-mail to some other guy, copying me in. Doesn't actually reply to me. A-hem.

Nothing happens.

Third month I get ANOTHER bill, this one telling me I need to make arrangements or I will be receiving a call from collections. {Steam beginning to trickle from ears.}

SO. I backtrack to the original doctor who told me to go to this person in the first place. I e-mail her (the diabetic specialist), and ask her to call either the dietician or the billing people and give them the right freakin' code. I also e-mailed the billing department to tell them that I am NOT paying this bill, in part OR in full, because it was coded wrong (not my problem) and my insurance will cover it once they straighten out this mess.

As a person who deals with appointment after appointment, and as a person for whom stress exacerbates MG symptoms, I DO NOT NEED THIS!!!

I'm VERY thankful that I have insurance. I am very that it covers as much as it does. Otherwise, I'd be in the poorhouse. When it's right, it's fantastic. When it's bad, it's UGLY bad. Can I get an Amen?!?

I also just had to file a claim with the insurance company (this is what the docs normally do) for the new trach I got after I had my surgery. I had to get this piece of paper from the doctor, that piece of paper from the manufacturer, file this paper here, and that paper there. I filled out this form, and dotted that "i", crossed this "t", gave them my social security number, blood type, and promise of a second born child, should I ever have one.

And it still won't be enough. They will send their beautiful form letter, telling me I need to jump through THIS hoop, not THAT one, and that IF I stand on my head with a pink tutu on, AND if I walk backwards on my hands 3/4 of a mile, they MIGHT cover about a third of what I actually paid.

So I guess there's only one thing left to say: God Bless capitalism, and God Bless the USA.

1 comment:

Joanna said...

Yikes! Doesn't sound like fun. I'm constantly getting those emails of train to be a med. transcrpt. Gee, if you're bored (wink) go for it. *hee hee*

Glad I got to see you today! :)