Monday, May 18, 2009

Dealing With Those Medical Bills

I just got done dealing with a slew of medical billing from the birth of my twins. I use the term "done" loosely, because I never know when another bill will go through... could be two years from now! (I've had that happen before!) Anyway, I have a few tips to offer from my experience. I'll get to that now. If you want to enjoy some rants on healthcare/insurance angst, read on past the tips.

Tips for dealing with Medical Bills and Insurance Companies
  • Start making the phone calls as soon as you get the bills.
  • You can almost always get a discount for paying your bill off in one payment, so ask for a discount.
  • Document everything! Get a scratch paper(s) and record the date, time and person that you talk with each time you call.
  • When you find someone who is nice and actually willing to help you, get their extension and keep working with that person through the whole process. This saves time so you don't have to rehash your story every time you call.
  • When someone doesn't return your call, call them back every day until they do.
  • Don't get nasty. Be nice and a bit aloof so they don't feel threatened. (It must be awful to have a job like that, afterall.)
  • Ask lots of questions so that you understand every charge perfectly.

I'm very grateful that we can afford health insurance. That said, I will now whine about the system. There are layers upon layers of bureaucracy that make it very difficult to receive the service I think I deserve since I'm paying the premiums.

Without going into too much detail (because what could be more boring that reading about a medical billing error in your spare time?), I received two bills, one for each baby, that detailed pre-certification penalties to the tune of some $1000. After hours on the phone with the insurance company and the hospital, the case has been mostly solved, no thanks to my insurance company.

Get this, my insurance company Cofinity delegates its claims processing to a company called Meritain. Layers of bureaucracy. So, I called Meritain some 15-20 times and nearly every person I talked to must have been trained to get me off the phone. Most offered trite reasons for the penalty and every time I tried to challenge them, they came up with some new story. In my last ditch effort to deal with Meritain, I contacted a supervisor, whose first name was Eric. He seemed nice enough, listened to my issue and told me he'd work on it and get back to me in a couple of days. That was over a month ago. Yeah right. What about "get back to me in a couple of days" did he not understand? I even called him back a few times and each time, got his machine.

At the same time that I was dealing with Meritain, I had called the hospital's billing department and basically demanded that they start a dialog with Meritain since they had the records of the pre-certification process and knew the jargon. They did. It took 6 months to get to the bottom of the mess. I called and check up on them all the while. It ended up being an error on the part of the hospital. They hadn't pre-certified my twins in accordance with the requirement outlined in my policy. Picky, picky, picky. They appologized and waived the penalty.

Now what would have happened if I had accepted this penality? My savings account would have been $1000 lighter. How many times to errors like this happen? I think too much. This isn't the first time (or the second or third) I've encountered an error like this. It happens far too often. And no one is watching it. If we consumers don't watch, we'll get hosed without even knowing it.

There is no industry quite like the health insurance industry. It stinks. It needs an overhaul. Don't think I'm about to advocate government health care. I have done the medicaide thing while me husband was in school and that system is riddled with problems... among other things, it encourages this empty sense of entitlement that isn't good for anyone.

I think the insurance revolution starts with consumers. We have to say no to silly fees and penalties. We need to hold these companies accountable for the service they are supposed to provide.

Lindi is now stepping off her soap box.


4 comments:

  1. I hate babysitting each and every claim that gets made to my insurance. It is a timely and tedious process but well worth the efforts made. I have saved a lot of money over the years! I use all your suggestions and that is what gets results. Thanks for sharing.

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  2. What really gets me is how the employees at the hospitals always say "it was a computer error" when we all know it was a human error, or was it an error? Some hospitals take advantage of insurance companies and will put an item or two on the bill that wasn't paid by a person who didn't have insurance. It's best to ask for an itemized bill then have the attending physician
    check it. My daughter had an operation and our insurance got charged for 8 items that wasn't part of her bill. Took 18 months to get that straightened out. Thanks for the great post.

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  3. Yes, I got that computer error excuse when I was charged twice for the same procedure in one day. No one saw anything strange about that... except me, of course, who called the provider. I told them I was pretty sure I had only had the procedure performed once that day. It was an obvious mistake... a human error! Where is the accountability anyway?

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  4. I currently have First Health which also processes through Meritain. Nightmare of a company with which to deal. Have had almost identical experience regarding customer service. They always blame First Health. You are not alone in this battle with Meritain.

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