Health Insurance, part 22... only half done?
Well, it turns out that I won half of the appeal. How could that happen? I have no idea. The issue, it seems, is that they're willing to overturn the previous decision on the doctor's bill, but not the hospital bill.
This is something that I actually found out about last week. Surprisingly, though, I didn't have time to deal with it all. Suffice to say, I called up the insurance, and had them explain it to me. In order to continue, I need to pursue the following logic:
1) The payment on the hospital bill had been maxed out at $5,000, which leaves about $5,000 left.
2) Although it was an outpatient procedure, the doctor decided that I needed to stay overnight in the hospital. This is apparently where the charges come from.
3) Going into the operation, I didn't see this charge coming, because it wasn't supposed to happen. Therefore, it doesn't seem like it should fall under the part associated with the surgery.
Of course, couple that with the fact that they didn't return a response to the appeal in time.
I still need to talk to the hospital and figure out how this all got charged.
The more recent news is that I'm trying to figure out how to pay for all the few-hundreds of co-payish charges from the doctor bills. Since it went to collections (and shouldn't have) it's all a complete mess. Insurance paid for something, but the doctor's office billing people couldn't tell me what that was for. Additionally, they've differentiated between the doctor and the otolarynologic foundation to the point where they can't tell me what's going on with the other bill. Still, they're connected enough that when I tried to phone the otolarynologic foundation, I somehow reach the doctor's office.
The amount that the collections people want from me is not equal to either of the amounts on my Explanation Of Benefits. Hmmm. I've called them up to have them explain this to me. We'll see what they say.
As people have mentioned to me, apparently part of the strategy is that the patients will just give up. As it is, I'm losing a lot of time working on my thesis, as I'm forced to spend entire or large pieces of the day here at home so I can make all these phone calls.
It looks like I will need to send yet another appeal. In addition, I should send more notices/complaints/something to people at my school.
Ugh.
-Kyle
This is something that I actually found out about last week. Surprisingly, though, I didn't have time to deal with it all. Suffice to say, I called up the insurance, and had them explain it to me. In order to continue, I need to pursue the following logic:
1) The payment on the hospital bill had been maxed out at $5,000, which leaves about $5,000 left.
2) Although it was an outpatient procedure, the doctor decided that I needed to stay overnight in the hospital. This is apparently where the charges come from.
3) Going into the operation, I didn't see this charge coming, because it wasn't supposed to happen. Therefore, it doesn't seem like it should fall under the part associated with the surgery.
Of course, couple that with the fact that they didn't return a response to the appeal in time.
I still need to talk to the hospital and figure out how this all got charged.
The more recent news is that I'm trying to figure out how to pay for all the few-hundreds of co-payish charges from the doctor bills. Since it went to collections (and shouldn't have) it's all a complete mess. Insurance paid for something, but the doctor's office billing people couldn't tell me what that was for. Additionally, they've differentiated between the doctor and the otolarynologic foundation to the point where they can't tell me what's going on with the other bill. Still, they're connected enough that when I tried to phone the otolarynologic foundation, I somehow reach the doctor's office.
The amount that the collections people want from me is not equal to either of the amounts on my Explanation Of Benefits. Hmmm. I've called them up to have them explain this to me. We'll see what they say.
As people have mentioned to me, apparently part of the strategy is that the patients will just give up. As it is, I'm losing a lot of time working on my thesis, as I'm forced to spend entire or large pieces of the day here at home so I can make all these phone calls.
It looks like I will need to send yet another appeal. In addition, I should send more notices/complaints/something to people at my school.
Ugh.
-Kyle
posted by Kyle at 9:38 AM
1 Comments:
Monkey, I've said it before and I'll say it again: Get A Lawyer.
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