A month after my reaction to
blood pressure medication, we received a bill for over $1,080 (US) from the
emergency services billing company. I called to question and was told that the
ER doctor was out of our provider network, we were responsible for payment, and
I needed to file any appeal with my insurance company. If that organization refused
further compensation I should call her again, she said, promising her employer
would work with us (presumably an installment plan).
I spent a few hours calling
back and forth between these corporate entities. Our insurance provider insisted
we only owed $75.44 and the billing company had no right to demand payment of that
declined balance. An opposing customer service rep insisted that was untrue,
that the insurer had no right to limit the amount due as no contract existed
between these two firms.
At last, a woman with our
insurer told me she put in a dispute on our behalf with the billing company. What?!?
Confused as I am, I don’t intend to drop the matter.
Fast forwarding to the
afternoon, I told my primary care physician when he asked about my stress level.
Steam practically pouring out his ears, he admitted a lack of expertise but
expounded upon his opinion. He thinks our insurer knows full well their company
is responsible for the $1,080.
My doctor believes both enterprises
hope the patient pays without question, satisfying the greed of each. Lots of
folks cave into pressure from this extortion, he explained. My husband
would have been one of them, sad to say. In fact, Dr. S maintains utter disbelief in the ‘out
of network’ explanation.
I guess my next step is a
friendly call to the ER facility, or perhaps a personal visit. Then, in about a
week, I intend to call the biller’s representative for information on the
insurer’s alleged petition and proceed from there.
Ugh…
Meanwhile, a lingering lump
on my scalp grew three times larger over the summer. My hairdresser classified
it a harmless cyst (called a wen) and advised having a dermatologist remove the
cumbersome bump. I mentioned this to a medical student during her initial
consultation, she passed it on to Dr. S, and he (fulfilling his residency at
this clinic) consulted a senior physician before she followed up on their examinations.
This attending physician assured
me their procedural department could remove the cyst, which insurance would be
much more likely to cover versus a dermatological procedure. In addition, she kindly
spent valuable time accompanying me to the checkout desk so as to assure both ideal
scheduling and proper insurance coding. For one $20 copay, I will undergo this
little outpatient surgery and receive a surreptitious follow-up on my blood pressure. Nice, huh?
Whew! I’ve rambled enough. But
how nice to find caring, competent professionals. Wish me luck on the other
mess.
Have you heard of a wen
before?
