Insuance Sanity

After my bought of doctor care and in and outpatient visits, the cycle of working with the billing offices of both clinic and hospital and insurance company has begun.  The most frustrating part is the varied bills that come from clinics and specialists I didn't know were even part of my case.  Radiologists look at one set of tests and images, and send a bill, pathologists look at others and send a bill.  Even though all are part of the same medical system, as the patient, the bills still come separately to you.  Sometimes they look like bills, but they are just statements.  Other times they look like it is a statement of activity, and I learned, no, an outstanding bill. On top of this, a  routine well child visit for my daughter has gotten into the loop as an unpaid bill, though should be fully covered as preventative.  (The claim was initially denied because we apparently were supposed to notify our insurance provider that we don't have other insurance coverage on her, as if we would be looking to pay for two separate policies.)

All of it is enough to make a person with good business sense cringe, and those of us that like things consolidated and concrete, go a little mad. How do you go about sorting it all back to rights?  We know we will have considerable out of pocket expenses due to neither my or the family deductible being met, but we also want to make sure we don't overpay out of pocket for the treatments and visits that were 100% covered, or paid as part of the office copay. So far, we have just logged each piece of mail, with the case/billing number, so that we can do a cross walk.  Next will be to do a review with the company, and verify what might still be in process, and what truly is going to count against the deductible. We carefully looked over everything that was included in each bill for any abnormalities. We have already found at least one "procedure" being billed for that was not part of my health care, confirmed by clinic staff.  We are working to get that removed.

I am fortunate that I had my husband with to hear all the details of what was done prior to surgery, and what would happen after.  I was  aware enough at the clinic visits to ask questions, jot done the answers at the visits he was not with me, so we have a very comprehensive set of notes.  Unfortunately, we have learned to do this because of past issues in fighting with the  insurance company for coverage. It is very hard to track it all, particularly when you are not feeling well.  It is essential to have someone with you that can ask questions and make notes if you yourself cannot.  Find a trusted family member or friend and don't try to take in all the information yourself.   The staff at the business office and the insurance company are just doing their job, but it is important to make notes and get names, dates, and specific actions when you talk with either. We learned that even though we had confirmed single insurance for my daughter and were told the claim would go forward, a simple "forward" to the claims department for review didn't happen, thus resulting in yet another bill from our clinic. I'll have to check back later in the week to verify it has been handled this time, and not assume it has.

I am grateful for the care I received this fall and early winter.  I had terrific staff and medical professionals that treated me with respect and professionalism. This post is  not to condemn any part of the medical billing and insurance cycle, but rather to give notice to others to be diligent on the financial side of health care. No one needs to learn months or even years later that there was an outstanding bill hanging over their head.  While this bout of "call the insurance company" is bothersome, I am confident it will get sorted out and to rights in short order because we are being diligent about tracking the details. Have a healthy week.

Just a smattering of the invoices and statements we received in the last two weeks.