Insurance Billing Mistakes

dogsandjogs · January 2014

I have had a lot of problems lately with providers ignoring what the insurance EBO says I should pay and asking for a higher amount. Usually they will correct the bill, but I resent having to call them and not even getting an apology. Last month I got a bill which was higher than the insurance co. told me I needed to pay so I corrected their figures, sent a check for the correct amount along with a copy of the EOB.

Today I get a bill for the difference that they say I owe and say it is a 2nd notice. So frustrating - it seems they ignore all the explanations and just re-submit.

I also got a bill recently from my city's fire dept. They responded to my 911 call and I was billed by the ambulance people AND the fire dept. I called them - they said they don't charge for 911 calls (I didn't think so) waiting to get that bill resolved. Sigh---I guess I shouldn't let these things get to me, but I feel so helpless and worry about my credit rating.

Anyone else have these problems?

Chickadee · January 2014

Every bill I get from the clinic or hospital has been wrong. I hate it to but I never pay them until I review. Most of the time they just write them off. I don't know how they function financially.

dogsandjogs · January 2014

I think the problem is they overbill to begin with. My one month of physical therapy for my broken arm cost $4,400. That was for 12 visits!

Of course insurance wouldn't pay that amount and they had to write off most of it. My 20 percent co-pay was $139----

Glad I'm not alone in my frustration!

BayouBabe · January 2014

Want a laugh? In the beginning of my diagnosis, someone miss coded something and I was getting these huge bills that weren't being covered. I called insurance and found out is was for sleep apnea and urine tests. The insurance woman began arguing with me that I had so many procedures done, maybe I just didn't remember these tests. My husband was rolling on the floor laughing as I began hollering at this woman that I was perfectly sane enough to remember if I had peed in a cup recently.

dogsandjogs · January 2014

Ridiculous, but funny!

Chickadee · January 2014

and guess who got a bill from the RO office today.......and it's all wrong. Making up my little spreadsheet. Such fun, such fun.

NatsFan · January 2014

Oh, yes - the battle of the bills. I got in the habit of logging into my insurance company portal to track bills religiously - the minute something looked wrong I called until I got it straightened out. I got started doing that after my first surgery. The night before my BMX I got a call from the hospital saying that insurance had been denied for the hospital being out of network. The hospital would not admit me until we made some outrageous deposit upon admittance.

The hospital absolutely was in network, and I called the insurance company immediately. I'm arguing on the phone with the representative - I was on their website and the hospital was clearly listed, but he kept insisting that it wasn't listed. The hospital's billing office finally took pity on me - they said they knew that they were in network for my insurance co, and obviously something got coded wrongly between them and my insurance company. They agreed to admit me without the huge deposit. As you can imagine, I was a wreck that night - here I was newly dx and new to all this, and had to go through this wringer, with thousands of dollars hanging in the balance. Not a great way to spend the night before surgery. Of course it all worked out in the end, and my insurance company covered everything.

carol57 · January 2014

It's a nightmare out there! I met with an onc locally; she has hours one day a week at our local hospital. Received a bill from her home office plus a duplicate from the local hospital. That took months to resolve--two identical bills for the same visit, and neither seeming to want to concede that theirs was the erroneous billing.

Another time it was an MRI. I was given an estimate of about $480 for my out of pocket at the time of the MRI. Got a bill for more than $4,000, my responsibility because we're on a high deductible plan and had not met that yet for the year. I questioned it and was told it would go to audit, and then was told I had indeed had the MRI so that was that. So I escalated my complaint, twice. Finally someone realized that the charge for reading the MRI had been put into the billing system with a quantity of 10, and they reduced the bill by $3600. That was six months of me refusing to pay and being told I was in arrears. I held my breath when DH and I refinanced our home for a lower rate last year, wondering if there would be any credit-score 'dings' for medical bills, even though we always paid what was eventually identified as our responsibility. Fortunately there were no bad reports, which tells you that the whole system just expects payment to take months and months and months. To say there ought to be a better system doesn't scratch the surface of what's wrong here.

DivineMrsM · January 2014

One of the stressful parts is when you speak to an insurance rep on the phone. They can be so rude and seem so cold and calculating. They don't want to cut you a break and don't seem to be human or take into consideration that on top of the bill, you are dealing with an illness and may be feeling simply awful. Some of the reps are just plain incompetent. I guess we should at least be happy they aren't incompetent doctors?

dogsandjogs · January 2014

I actually have had only positive experiences with my insurance company. It is the providers who give me a hard time. They don't want to admit that they used the wrong code and if they do admit it, they won't apologize and are annoyed that they have to re-submit a claim. One time when I explained I was not responsible for a bill they sent, their response was "Well, somebody has to pay it!" and then she slammed down the phone!

carol57 · January 2014

dogsandjogs, I have the same experience. Every time there's been an inappropriate attitude toward questioning and resolving an invoice, it's been a person in the provider's office that was rude. Our insurance reps have always been very helpful, often initiating conference calls while we talk with them--they get the provider office on the phone and guide the conversation to help straighten things out.

Chickadee · January 2014

I think its what we get at $8 an hour.

YoungInCancerLand · January 2014

Sorry to hit this thread with this. I'm not sure where else to post it. I'm glad I'm not the only one. I've been having issues myself with scheduling and insurance (just one example is that they billed my dad's old insurance - I have no idea how they got the number. I'm 30 years old with my own insurance number!) so much to the point that I sent a letter objectively outlining my concerns with the practice. I received a phone call today from the office manager - first words out of her mouth were I'm so and so, I received your letter, and I think you should transfer services. She then invalidated me and all of my concerns stating that they were accommodating to me when I'm the one with the insurance issues, and they were kind enough to work with me on it. She pretty much implied that I was a troublemaker, and my concerns were unfounded. She wanted to argue point by point in my letter which I did not want to do on the phone. I just wanted to provide them an outline of my concern and move forward. It was the most stressful phone call and thing I've had to deal with. I'm not even sure what to do.

YoungInCancerLand · January 2014

Carol and dogsanddogs - I'm having a similar experience. I'm just floored with they way they are reacting.

juneping · February 2014

i hate these bills coming in. i had no idea that my doc charge me copay and the hospital charge another copay....i am staring at the bills and just felt so lost.

the doc has a hardship program and gosh my disability is still pending...felt like a reflection of my life - pending.

AmyQ · February 2014

Last year in the middle of my surgeries and chemo I got several letters from my insurance company saying they overpaid some of my bills and that I owed them $243,569.25 and 722,286.20 and 469,873.19 and $555,245.66 It was all so completely ridiculous all I could do was laugh!!! I knew they were wrong and I knew if I called them, I'd get upset, so I filed the papers away and I never heard from them again. Ha! Easy come easy go?

juneping · February 2014

wow...that's was insane!!!!

Chickadee · February 2014

juneping, don't assume the co pays are yours to pay. '

You don't mention insurance or Medicare. Question the bills. Find out what you are and are not responsible for.

juneping · February 2014

chick - it's insurance. i asked the hospitals...both said two separate bills (doc + hospital)

i looked at the bills from hospital, i am paying what insurance didn't cover...like less than 10% of the bill. how do i know it's my bill to pay or not? should i call my insurance up?

i am looking at the dates of the bills and the dates are legit but the only ? i have is do i need to pay that? most of them are 2 digit bills...just when they add up it's got to close to 4 digit because the surgon bill was 400 bucks.

dogsandjogs · February 2014

Call the insurance company and ask them about your plan. They will know how much your deductible is, how much your co-payment is, etc. You should also have a booklet which explains everything; but it is easier to just call them.

juneping · February 2014

thanks ladies...i called and they went thru each bill with me.

i feel so much better. the bills were pretty much accurate give and take a couple of bucks.

teaspoon · March 2014

My hospital bills and insurance EOBs are starting to roll in for recent biopsies (1 cancelled, 1 aborted, 1 successful). So far, I've just seen the bill for the first in this series. I was astonished to see that the hospital billed my insurance for the stereotactic procedure (and was already paid about $5000) even though the scheduled procedure did NOT occur and was actually cancelled in the room (yes I was on the stereotactic table, but no meds/injections/biopsy attempts happened). The surgeon, who was in the room and made the decision to cancel the procedure, was also paid separately (a charge I expected and don't question). I called my insurance company and they said that any disputed claim for the procedure is between me and the hospital. I called the hospital and they are requesting a letter from me detailing my complaint. The hospital billing department would not give me the procedure codes they used for the claim. Any of you have a similar experience?

Insurance Billing Mistakes

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