I recently went to a new physician's office to get some shots and tests done for a Nursing program I am applying to. I needed a TB skin test, Tdap shot, and titers for MMR, varicella, and hepatitis B and C.
I went there in person to fill out the new patient paperwork and gave them my insurance information (I'm a dependent on my dad's insurance, BCBS of Illinois from his work). The next day, I called to schedule an appointment. The receptionist I spoke with told me that my insurance will only cover the TB skin test. The rest I had to pay out of pocket for. Of course, I assumed that they had verified with my insurance beforehand so I agreed and set my appointment for the next day. After getting the shots and my blood drawn, I was once again informed that only the TB skin test was covered and I was met with a bill of $270. Although it will definitely set me back, I went ahead and paid it (Broke college student). When I left, I just couldn't shake off the feeling that something didn't feel right. I called my insurance company and asked if they covered for the shots and tests I had done. The representative I spoke to said that they do cover them for all in-network physicians. I also checked with her and found out that the physician I just saw is in-network. I went back to the office and asked one of the medical assistants about this. She stated that insurance companies say that all the time but not all of them will pay and that if I really wanted to, I can wait 3 months for an EOB (Explanation of benefits) from my insurance and bring it back to the office. I left.
Still not satisfied, I came home and called the insurance company again. This time, I explained to the representative everything that had happened starting from when I submitted my new patient paperwork to my conversation with that medical assistant. She told me that she does not see a record of that office calling them to verify my insurance and that she will call the office to find out why they billed me first even though my insurance does cover everything I had done that day. With me also on the line, she called the office and we spoke to someone whom I assume takes care of billing/insurance matters. His reason for why they charged me directly is because I am a completely new patient with no medical records and that that is their way of protecting their business, which is understandable but also completely unacceptable because I was not told this and was given false information about my insurance. When I confronted him about this after visiting the office again the next week, he told me that sometimes the insurance will pay and sometimes they won't so the staff members just say that the insurance won't pay to make the process easier. Ridiculous! I was told by that same guy told that upon receiving the bill, their office will have an additional 60 to 90 days for the doctor to sign off on the bill until they can reimburse me.
As of right now, I am waiting for my insurance company to receive the claim and pay their portion of the bill. I am feeling lost, confused, and frustrated. I honestly don't even know what kind of advice I should ask. The money, although it is a large amount for me right now, is a minor concern. I just don't want to pay more than I should. Is there anything else that I should've done or can still do?
Submitted April 03, 2018 at 09:39AM by Yumiyuko https://ift.tt/2GzpwpN
