Thursday, November 1, 2012

Blame Game.

Why is it that insurance companies get such a bad rap?

Let me share a little experience with you.  I was referred to a specialist by my regular doctor last year.  When I got to the specialist's office, I had to in the waiting room for an hour before the nurses called my name, so when I heard it, I jumped up and all but ran to the nurse with the clipboard.  She promptly directed me to a second waiting room where I stayed for another half hour.  Finally my name was called again, and I made my way (slower for round 2) to the nurse who deposited me in the room where the doctor would see me.  I waited another half hour to see the specialist.

After 2 full hours of waiting (what's the point of an appointment?), the specialist came in and confirmed the original doctor's diagnosis.  It took all of 2 minutes.  He then told me to make another appointment to come back to actually get treatment for the problem which he (and I) already knew I had prior to the appointment.  I asked if I could receive the treatment (an ultrasound) that day and was informed that the ultrasound technician had already gone home for the day.  I asked why my appointment had not made during a time when she was available.  They said they didn't know.

Fast forward 2 months (yes, I had to wait 2 months for the original appointment and 2 months for the follow up apointment.)  After much waiting room time, I managed to get things taken care of.

Fast forward another month, I received a $50 bill in the mail.  I called and asked the nurses what was going on with the additional bill.  They said that a $50 co-pay had to be collected for the 2nd visit.  I informed them that there should have only been one visit and that they had made a mistake by not scheduling my original appointment at an appropriate time so that I could receive an ultrasound.

Do you know what they told me?  "I'm sorry, but that's the way your insurance company billed it."

What the heck?  I told them that I was pretty sure that insurance companies didn't send out medical bills.  Doctor's offices sent out medical bills.  Insurance companies PAY bills.

She told me to call the insurance company.  BlueCross BlueShield (an awesome health insurance company, btw) told me that the specialist's office could bill it as a visit and a consultation (or something like that) so that I wouldn't be charged a second $50 co-pay.  I called the nurses back...had an frustrated...and waited for another call from the manager. 

Anyways, that's a super long story, but my point is that the doctor's office wanted to let the insurance company take the fall, and most people would have just accepted that.  The nurses made a mistake (maybe they did it on purpose...greedy) and didn't want to take responsibility for it.  Insurance companies have to make money, and they're not all perfect, but many want to help people. They aren't always the bad guys. 

Also, my husband can hook you up with health Jake @ 252-752-8821.

1 comment:

  1. We are switching to bluecross blueshield in January (rob's work's choice - not ours) - but I'm curious to see how it will compare to cigna. My dr's (so far) are usually good to bill things the best way for me. The insurance, however, has screwed at least once (although, lots of insurance companies screw up when twin birth billings start)...