Medical Bill - Since WHEN?

[Jennifer]

I have Medicaid which is USA government run health care. Only thing I have to pay is $5 every time I got to the ER and I'm fine with that. But I just got a bill in the mail for a blood test. D:

The Thiopurine Metabolites. My insurance paid $39.54 leaving me with a $230.46 bill. It states, "Your insurance has determined that these services are not covered by your plan." Well then why did you pay even a little of it?

The date the insurance was billed was 11/02/2012. I wasn't even taking 6MP anymore (which is what this test is for). I was on Humira at the time. Or stopping it and switching to Remicade.

Either they got the bill late and decided I didn't need the test because I wasn't on 6MP anymore and didn't need it OR someone made a major boo boo by allowing the test to be done even though they knew that my insurance wouldn't cover it. No tests are done unless its approved by my insurance so why was it done if its not covered anymore?

I have to wait till Monday to call the people who want their payment to try and figure out how to get this straightened out because it really doesn't make any sense. Just venting here I guess.

 

[izzi'smom]

That stinks.
I'm super fortunate that most of the time dd's doc's office is cognizant about what is covered, but the one time that I sent all of dd's records (including slides from her scopes) to a new GI for a second opinion and got a $780 bill for path to re-read the slides...the insurance company not so gently informed me that it was my responsibility to know my coverage. I appealed the decision twice and got it covered but what a battle!!
Hate waiting for the weekend to end to get answers, too...but sometimes it helps me formulate my thoughts lol!

 

[Jennifer]

Thanks izzi'smom. I know all this stuff happened to my parents when I was a kid. Sometimes things just didn't get covered or not enough coverage and my dad's wages were garnished a few times because of my medical bills. This is the first time I get to deal with it on my own because I'm usually told, "no, you can't have this test/med/doctor because your insurance wont cover it." I'm going to appeal if for sure cause there's no way I can pay for it.

 

[SarahBear]

Incredibly frustrating, Crabby. I'm sorry.

I'm having a similar situation - I moved last July, and when I did so, I called my doctor's offices to give them my new address. They apparently didn't pass it on to all the anesthesiologists, etc. who bill also so the bills went to the old address, weren't paid, and were sent to collection.

Medical bills are never easy, are they?

I hope your situation gets worked out soon!

 

[Niks]

it must be horrible to have to worry about medical costs on top of everything else!

Really hope you get it sorted. Good luck x


:ghug:

 

[Ihurt]

I am so sorry, that is so frustrating. I would definitely call on Monday and see what happened. I mean you are right, If it was not coverd, why did they pay any amount at all?? That just makes no sense. I think someone maybe made a mistake on their part. Maybe it should have been covered and someone handling the bill just messed up. Hope it is as simple as that and they can fix it. You should not have to pay that bill....

 

[Jennifer]

Thanks everyone!

I called the billing department today and spoke to a rep there. She was really nice and called my insurance company for me. She called back to let me know that it is covered by my insurance.

Guess they really didn't have all the correct billing information because I used to have many different insurances back in 2002 (on the bill it showed that that test was covered back in 2002) but now I only have one. They also had a very old phone number so maybe they tried to call, I dunno. At least they had my current address and I was able to get it sorted out today. Don't have to pay a dime.

 

[izzi'smom]

So glad for you...and TY for the update!!

 

[LisaL]

Yay!! It always pays to push a little bit to see what is going on. Insurance companies will sometimes reject a claim or refuse a test because the individual who reviews the claim just didn't understand the paperwork. It sticks, but it is worth fighting.

I'm glad this one got settled so easily!
-Lisa

 

[Hope345]

good to hear.
lets hope that insurance companies start paying for the fecal cal protectin soon. We are up to @$650.00 .... from last year alone.

Not sure if they will be retroactive, but I am waiting for the results of our second appeal.

I cant believe they would not see how much this test helps our kids, and saves them money at the same time. It is far less invasive and less expensive that a colonoscopy. I just feel there is a need for both.
sorry i added to your thread, just reminded me about this.

 

[tots]

I was billed for a treadmill I never had. Two years later. The auditor said you just didn't know you had it done.

1- you called me at work.. at a drs office, I know what it is!
2-I had my first baby that day. July4th, hard to forget!!

Lauren