Insurance Junk, part 15

Okay, this merits its own post, since I need to keep this as a record for myself.

First, I called the BMC. They like my explanation just fine (surprisingly!) and told me they could put a 30-day hold on my account (the computer won't do anymore than that). They said to call back when they get in touch with me again. They were very nice on the phone, so no problem.

I had gotten a letter from the BMC, but also from the Otolaryngologist, so I opened that up to call them back. I was in for another surprise: the charge here was a new amount! One might think that this was due to some sort of interest or something, except this charge is lower! Crazy!

So, I called up, now being very curious on top of wanting to explain my situation (again). It seems that one of the pieces, an $830 charge on the bill was backed out and resubmitted to insurance because they found a better procedure code to submit with. Wow! This was submitted to Aetna between 9/13 and 9/17.

I asked exactly what I should do now, and the person there (who has helped me through this mire for the past 10 months) simply said I should call back after I hear from insurance.

Now, for my own benefit, here's the sequence of events that needs to occur and what I need to do:

1) Hear back from Aetna about Otolaryngologic bill.

2) Hear back from Aetna about Pathologist Bill.

3) Make sure everything's in order, then submit appeal to Aetna.

4) Call Otolaryngologist to update them.

5) Who knows? I hardly understand how this works!

Awesome.

Health Junk, 14

Updates are apparently what this is all about. In fact, there are apparently some people reading this, and enjoying the ride of pain that is me trying to figure this out. Glad I can bring smiles to someone :-P (Please feel free to comment if you're enjoying this!)

Well, after still not hearing from the Pathologist Billing people, I called them back this morning. Huge update: Yes the code change had gone through! Hurrah! (Sure, they decided not to call me to let me know the good news, but... why keep the patient in the loop? (I had asked to be let know immediately, every time I called them!!!))


So, now the following things need to happen:

1) hear back from the insurance. Apparently this should take around 30-45 days.


2) Receive the new Explanation of Benefits from insurance. (Is this how I'll hear back? Who knows. Communication in any form with me hasn't exactly been top notch here.)

3) File an appeal of the way my claim was handled.

4) Crawl in a corner and expect them to deny it.

5) Find myself in a horrible hole of debt. Awesome.

I will now go and call all these other people that have sent me letters asking "Where's our money?" I don't blame them; the operation was ten months ago. How am I supposed to explain that it just now looks like my claims are going to be billed correctly? Especially when these bills are not from these people that want their money.

Ugh.

More later. Apparently in 30-45 days.

Health Insurance 13

On September 20th, I got a message from the pathologist billing saying the account had been brought up with coding and there was a hold put on the account with collections. Okay, I sorta knew that already.

It's been three weeks since then (they were supposed to get back to me in two, which they did, but I hadn't heard from them in another three)
so I just called them up.

I don't really mean to be confrontational on the phone, and I don't exactly think that I was. It's likely that dealing with any of this puts one's nerves on edge, however. The conversation when like this:

"Hello, I was told to get in touch with you if I hadn't heard back in three weeks."

"Okay, well, we left a message for you on the 20th."

"Yup, I got that."

"That's when we sent out your request to coding. It should take about a month from them to hear back."

"Oh. Do you know why it took so long to get to collections?"

"Well, we sent it out on the 20th. We don't have any record of sending it out before then."

"I called back in August..."

"We see a call from you in the first week of September. Oh, and we apparently put it in the bin on August 27th." [she might have said the 25th; I don't recall]

She quickly changed the subject from the fact that my request was sitting in some elusive bin for nearly a month: "Once it's in coding, we can't do anything until we get the response from them. You should get a call in the next week and a half."

"Okay, thanks, bye."

Once I have time to get on the phone and call people again, I'll get to explain to multiple parties that the thirty day extension on each of these bills was completely used up between transfers of my request, from one party to another.

More later.