Quote:
Originally Posted by J_is_my_initial  gonna make an enemy or a lot here but here goes:
I work for a call center for a company that supplies er physicians all over the country. So I talk to people about their er dr bills 5 days a week. I am wondering about something and just some thoughts about medical billing.,
Did you talk to the company before it went to collections? That is the time to ask for any review of possible mistakes in the billing. If insurance denies it for a coding error, the insurance needs to tell the medical group what they think wrong code is or we do not know. If the eob sent to us by the ins just says service denied or not covered then we have to send it to the pt. It is up to the pt to follow up with the ins. We can only bill it, can not make them pay.
Services were provided to the pt, it is the group's job to bill the ins with info provided. it is up the pt to make sure we have the correct info. If ins says not covered, it is between the ins and the pt.
If you ever suspect there is a coding error, ask for the coding to be reviewed. Med grps will do this. errors are made. but you have to ask while they still have the acct. If you get a bill do not assume that ins will take care of it. Call the first time you get a bill. We get calls every day from people who are mad their acct went to collections. We tell them the dates the bill went out to them(usually 4 times ). they say i thought ins was taking care of it. Call at the first bill.
If you need to ask your insurance to call the grp that is what you pay them for. If the bill has went to an outside collection you have to talk to them as the original biller no longer has the acct. Sometimes the ins makes mistakes too.
what code are they disputing? again it may have been coded correctly but the ins processed it wrong. When did you first talk to the provider about a possible problem with the billing?
Sorry everyone. I get so frustrated with people arguing with me about taking responsibility for the bills. Not saying this is the case here though. I even get cussed at when asking for some to provide the ins info. |
Yes, I did talk with both when all this started (years ago) and thought all this was settled long ago. Unfortunately, this was all over the telephone and I have nothing in writing from my initial calls to the insurance carrier. This time around, it will all be by mail.
I'm frustrated with both the Provider AND the insurance carrier. I paid thousands of dollars for insurance coverage and resent having to pay for a covered service because the Provider failed to bill correctly or the two are two lazy to communicate and it's just easier to bill me.
I just bought a new house last year - so my credit rating is good - and I'm not known for NOT paying my bills.
I understand your point; but I consider myself to be a reasonable person. I will argue the case to the best of my abilities; and while I work with attorneys every day - would probably not involve them in something this trivial. Ultimately, I only have so much time to devote to this provider OR my ex-insurance carrier and it could be cheaper for me in the long run - to pay the bill.
We'll see what response I receive and move forward from there.
Thank you for your insight from the 'other side of the desk' so to speak!