Wednesday, December 27, 2006

Fight For Your Money Re:Health Insurance/Time For Last Minute 2006 Tax Deductions !

Yikes!!! 2006 tax year coming to an end! I just realized that I need to go through some medical bills NOW and pay as much as we can RIGHT now. It is hard to believe there is only a couple of days left to do this and I will have to do it by phone.

With all the Christmas preparations and getting stented - I totally forgot. Dang! Not exactly what I want to be doing during this holiday week. We hit catastrophic with all the medical bills this year and I am sorry to have to start a new year with this stuff (physically and financially) not cleared up.

I started this great medical notebook this year because there was so much to keep track of, so that will help some. However, I let it slide the last couple of months and need to update everything. This is good though, because this project will jump start me in to getting our taxes itemized and processed early. (A girl can dream!)

***The insurance company and hospital billing dept. can drive you crazy! You absolutely HAVE TO BE ON TOP OF EVERYTHING when it comes to payments, reimbursements, etc. I feel sorry for the little old people, or people in general who think they can blindly trust these corporations to do everything correctly. Trust me here - ERRONEOUS thinking!

The radiologists, anesthesiologists and ED docs are NOT on our plan, which means I have to pay them 25% of the bill for their services. (They are killing me this year!) This past June, I called the ins. co and stated that I did not think it was fair that I am going to a PPO hospital and don't have a choice in which doctors service me, consequently resulting in a higher cost for me.

Guess what?? Turns out that since I DON'T have a choice, my insurance company will pay at the full PPO rate of 90% of the UCR charges. So, they sent out checks with an additional 15% reimbursement to the doctors. So, that worked for awhile and then they reverted back to paying only 75%! I called them again about this and the ins rep. stated that it only applied to the radiologists! we go AGAIN! I politely insisted that this was NOT the case - she disagreed- I assertively(yet politely) held my ground and requested a manager. She said she would submit it for further review. Suffice it to know that the checks for the 15% difference were sent out! Now they are doing it AGAIN! Also, I need to review all payments from last winter, including what I paid out. This will be work - all the phone calls, etc. Sigh!

The hospital billing department tried to double bill me 500.00 and something dollars for a bill from January!

First of all, someone at the hospital did not do their job in making sure I was pre-certified to stay the extra day and they had to eat 3- 4,000.00. I was responsible for the co-pay, which is the amount they were now in October trying to double bill me for.

Since I haven't worked through most of this, I needed to set up a payment plan with the hospital. We combined all the individual hospital dates/services into one big monthly payment plan.

I explained to the biller that this bill is a part of the original payment plan - THE 1st bill from the hospital for 2006 tax year. The biller maintained that I owe this money!

I have this uncanny ability to remember dates/numbers and so without anything in front of me but the bill they sent me for this - rattled off the dates for each hospital event AND explained that she was trying to bill me TWICE. She said she didn't understand and that I DID OWE the 500.o0 plus amount. (inside - I am beginning to feel like Steve Martin at the airport in "Planes, Trains and Automobiles!) Yet, I remained calm. :)

I asked her to get pen and paper and write down all the dates I was giving her. I then asked her if the info I gave her jived with her computer info? She had an epiphany moment and said "Yes - I see that is part of the payment plan and you don't owe us that extra amount.

And now we have touch down Houston! Gee - was she intentionally being obtuse, hoping I would cave, so she could collect some of the money they lost for themselves?

I am procrastinating - time to sift through the tax deductions..... I will be a happy, happy girl if I do get the taxes sent out super early!

P.S. I realize that most billing is done efficiently and correctly. They have to be up on all the current contracts (which can change at any time during the year) among other things and accuracy is key to getting a timely and proper reimbursement. I just know from my own experience that billing/insurance co. mistakes do happen.

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