What a field day for the heat
A thousand people in the street
Singing songs and carrying signs
Mostly saying, "hooray for our side"

Thursday, July 16, 2009

This week's healthcare issue

You might remember last week's adventure with a bill from last year. This week brings one that is a little closer. This bill is only from February. It's for a blood test. Bette spent an hour and a half on the phone with the insurance company, the doctor's office and their billing company.

Here's the first position of everybody. Insurance company claims they never received bill. Doctor's office verifies proper chain of billing. Billing company submitted bill twice, since they never heard back classified us as "not insured" (my doctor has had a policy for the past two years when you check in, not only do you make your copay then, you also must show a current insurance card) and listed us as "past due."

So, through out this the insurance company swears they never received a bill, billing company swears they put proper codes and billed twice, doctor's office is slightly helpful by providing diagnostic codes. After and hour and a half, this is what finally emerged. Doctor's office filled out their forms properly, billing company transposed diagnosis code (not the service codes, those were fine), insurance company did receive two bills but because diagnosis code was wrong (didn't relate to anything, just a blank) didn't acknowledge receipt of bill nor did they contact billing company to say, "wrong code." Billing company, not hearing anything (not an unusual circumstance) rebills with same paperwork. Again, insurance company doesn't recognize diagnosis, does nothing.

Now, they had the right insurance number. Every year we get one blood test without any diagnosis issue (if your sick they'll cover more). And the insurance company didn't deny the claim, they behaved as if they never received a bill.

Again, my insurance company is a name brand, I own stock in it (although am looking to sell soon), and is a major player in the health care industry.

Tell me again how this system is more efficient and cost effective than a single payor?

And while having two weeks consecutive of having to do this is unusual, having to do this isn't all that unusual (normally every other month).

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