My insurance coverage is horrible. And, like many, it doesn’t offer much coverage for infertility. Last year, it covered all of my ultrasounds and blood work. This year, there is a $1,500 cap for infertility. That was blown when I had my trial transfer back in January.
Or so I thought. I just got my bill today, and it turns out Emory never billed my insurance company for one.single.cent. The doctor apparently took it upon herself to tell the billing department *not* to file anything with my insurance company, and I’ll be damned if I’m going to pay their $1,500 responsibility.
Then, I noticed that I was billed a second time for everything I paid for in the office. I was required at every visit to pay for my ultrasounds and blood work, which I did. It’s a good thing I have those charges listed on my bank account statement.
After I got off the phone with Emory, I called my insurance company. I turns out, Emory only sent them four bills, all of which they paid. Those four happen to be the same ones I paid for out of pocket. The insurance rep was pretty pissed at Emory. You know it’s bad when the INSURANCE COMPANY gets mad at a provider. Basically, since the insurance company pays less than the billed amount, they most likely will cover most of the monitoring charges (u/s and b/w). And, I am due back the $1,000 or so I’ve already paid. With all of that taken into account, we should only be left with a fraction of what they are currently billing me. The insurance rep said that she thinks this will all be taken care of by the time the baby’s born.
I’m slightly pissed. It’s a good thing I got a pregnancy out of this or I’d be even more upset.
I am pretty sure that patient’s have the right to ask for a reduction of charges equal to what would have been reimbursed by the insurance company. In other words if they bill you $100 and the insurance company would pay $33 then you should be able to ask for that price-EVEN if your insurance company does not cover you for that service. Most do not know that they can ask–and I think demand this. I am not sure about infertility, but I think that if the clinic accepts insurance then they have to give you that price.
Wow… I didn’t ever think that a provider would be so unscrupulous!
I do believe SG’s right — if they’re accepting your insurance, they’re following a different set of agreed-upon prices … How the money is divvied up between your insurance company and yourself is irrelevant, much as beginning-of-the-year deductibles might come into play. But … “this will all be taken care of by the time the baby’s born.”?
So you go all this way for some contraceptive help … and wind up just getting screwed. Go figure! Perhaps this will seem more funny after the firefighters put out the clinic. =) Hang in there!
I wanted to pop on and check on you since I can’t link to your blog. That makes me sad. I hope the spotting has went away!!
Kami
Insurance companies are endlessly irritating to deal with. I’ve been having some testing done at a local hospital and their billing department can’t understand that even though I kept my maiden name, my father isn’t providing my insurance coverage, my husband is.
Hope you get everything settled!
Insurance companies can be a pain in the neck but sometimes it works out!
Good luck with these guys.
Hopefully it will all work out for you.