It always pays to check...

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Veteran Member

Date Joined Jun 2005
Total Posts : 2135
   Posted 3/27/2008 6:30 AM (GMT -7)   
any bills you get from your doctor.  I know this...but don't always follow my own advice.
My husband and I have a private medical insurance policy, for which we pay dearly. For the last 8 years (prior to 2007) we've been seeing our family physician only for an annual checkup, and some "follow up testing", I'd have a mammogram; he'd have a prostate exam.  ALL of this was covered (paid for) by our health insurance.  Then prior to 2007, we both got on Medicare, Parts A & B, and kept the private policy too. 
My husband got sick. We had to go to our regular doctor several times, and she referred him to a heart specialist, and he had to have stress tests and other heart-related testing done. And the bills started coming in.  I'd get these statements from Medicare that would say "we paid this much; your health insurance should pay part". And then from the insurance company, "we paid this much; Medicare should pay some". And there'd be a "remainder/patient owed" column.  So I paid that myself.  Several times.  Quite a bit of $$.  I wondered..but didn't check..just assumed that because the visits to the heart guy weren't a "usual" event, that in fact our insurance policy didn't cover that, and now that we were on Medicare A&B things changed.
Well, in early January I went for my annual physical.  And got the usual statements from Medicare and the insurance company about what they'd paid/not paid. Then over the weekend got a BILL from the doctor, for "remainder due!"  What??  This was just a usual annual physical?!  Why wasn't THAT covered??
So I called the insurance company and asked.
Turns out it should have been.  Turns out all the $$ I'd paid on my husband's behalf to the heart specialist should have been covered.  That the billing clerk in the doctor's office "keyed in the wrong code", and had been billing us! (And presumably, a host of other patients who hadn't complained, either!!)
So I saved $78  -- the amount I'd been billed for my annual physical. The insurance company suggested I "go after them" for the other amounts. I probably won't..but lesson learned. Well, more accurately, lesson re-learned. Next time I get a bill, I'll ask before sending off a check!
...I am not a doctor, nor health professional, and don't pretend to be one, here.....

Veteran Member

Date Joined Mar 2006
Total Posts : 2146
   Posted 3/27/2008 6:38 AM (GMT -7)   
Hey Uppity

O gosh! I do that all the time! My thought is always...'i'd rather just pay it than dig thru all that paperwork with them'...but shame on me! We actually found that we'd been being billed AND PAYING for a bill at a doc's office where another 'me' went. She was the wife of my husbands we had identical names...diff middle initials. Well she died! Yes, i had some calls to be sure i was ok...even my own twin brother called my husband to be sure there wasnt' anything he'd forgotten to tell them! hahaha So i'm paying for her bill AFTER her death. We finally just asked while in there one's not ours! We'd paid over $2200!!! We did get our money back, but geesh...we just decided to ask on a whim! Lesson learned for me too!
Co-Moderator, MS Forum
*~*Sometimes the Lord calms the storm. Sometimes He lets the storm rage and calms His child.*~*
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Regular Member

Date Joined Oct 2007
Total Posts : 343
   Posted 3/27/2008 7:11 PM (GMT -7)   
Uppity thanks for the reminder! I try to keep track of ours real good too just for that reason. My hubby keeps private insurance on us too and yes, it's expensive, but worst yet has been how "picky" they are getting with the tests etc... i.e. they refused my Nerve conduction test becos they felt it was "unwarranted"... go figure.

Definitely a great reminder though, I really dislike insurance companies and how they've become so horribly expensive and difficult to work with!
Fear knocked ~ Faith Answered ~ No one was there! :)
 ~ Ephesians 6:13 ~  * ~ Psalm 27:1 ~

Forum Moderator

Date Joined Jan 2007
Total Posts : 3552
   Posted 3/27/2008 8:10 PM (GMT -7)   

Hey Cat,

If I send you my claims and paper work for the family ( me, one husband, two sons) will you check all that for us??  We will pay you in doll house supplies and big smiles. :-)

Thanks for the reminder.

Gretchen       co-moderator MS board       diagnosed with MS July 2006

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