Friday, December 12, 2008

I am so pissed!!!

I know, I really wanted this to a family friendly website but I am just beyond upset. I feel kind of bad complaining when there are so many people more unsecure with their medical insurance BUT. . . I was opening Penelope's cardiologist bill from Nov 5 that came in the mail today. Jokingly, I said to Scott, "Merry Christmas, here is our cardiology bill." To my utter dismay, our balance is $502. I just didn't understand why the insurance paid so little. We had an appointment back in January and we paid our co-pay of $35 at the office, then the dedcutible of $300 and the $80 or so that was the 10% co-insurance, then another appointment in May where we owed about $80 after the co-pay.

It was only 5:15 pm so I called the insurance company and learned that our cariologist became out of network on Oct. 18. ONLY 2 WEEKS PRIOR TO OUR DATE OF SERVICE. Can you believe that no one told us that they were out of network. I mean come on, how are we to know? I asked the insurance rep that same question and she told me that I could always check online before every doctor's visit. It is nothing short of a miracle when we make it there on time, who has time to check online every time for doctors to be coming on and off network. Besides which, I passed my insurance card to the receptionist when I paid my co-pay, and she could have told us then. I made the appointment in September when there were still in network. I am just really frustrated about this. I even asked the representative for the other pedi cardiologists in the area to see if I could get on the gap exception angle, but there is a dr. in Vernon.

Because Dr. S is now out of network, we got hit with a $300 out of network ded, and then 30% for the co-insurance. Argh!!!

I plan on calling next week to argue the bill, but I think I am more upset that I have to change physicians on Penny. Dr. S has seen Penny since she was 1 day old. Plus we have to do that MRI next year. Any advise would be welcome on this subject.

5 comments:

My name is Sarah said...

Maureen, This is Joyce, Who is the carrier?

Melissa said...

Mo..You MUST appeal this with the OFFICE & YOUR INS! You made this apt BEFORE he became Out of Net. It is the OFFICES responcibility to notify their pt's when such changes are about to happen. You have NO IDEA WHAT GOES ON "BEHIND THE SCENES" while you're waiting for your apt to come! When they collect that darn copay, RIGHT THERE they should have known to warn you!!! IT'S CALLED REGISTRATION!!! Penny has been a pt since day 1....with all of the dollars this office has earned from Pretty Penny's services, THIS IS THE LEAST they can do by excusing this one time charge and RIGHTING IT OFF! It's bad enough that you have to suffer the consequences of finding another provider that you can trust with your daughter's life with not much warning time...definatly appeal this!! I am so discusted with their billing dept & I would also suggest for you to speak with the office manager of the CCMC billing dept;) Also mention to them how much $ you spent in the last 2yrs...Right offs are done everyday.
Good Luck!!

Cynthia said...

Good advice so far!
I just wanted to say, you certainly can appeal, and you should.
So sorry this bill had to come at Christmas time.
I'd be pretty mad, too!

Michelle said...

I would be so upset too! I can't believe that your appt was scheduled before he dropped that carrier and no one could tell you! I hope you're able to fight this.

Jess @ raising joey said...

Wow, I would be upset too!

About the website, you can always use wordpress and get your own domain name like mine. I only pay $10 per year along with $4.99 per month.