Thursday, August 23, 2007

Medical billing frustrations

I got a call from a collection agency today which surprised me. It seems the doctor's office messed up the billing information for Lorna's visit almost 6 months ago. The person who entered it put down we were a cash patient. We've never been sent a bill or had a phone call telling us there was a problem. In fact we were there not 3 weeks ago and no one mentioned they were having a problem.

I think we have everything straightened out. I called the billing department only to be put on hold and then hung up on once 4:30 hit, that is when they go home. I guess even if you call and are on hold before they close, if they can't get to you they just hang up and you have to sit on hold the next business day hoping the same thing doesn't happen.

I was frustrated to learn that they have an address and phone number on file that is almost 6 years old. It seems that there was a glitch somewhere and the correct information was sent to everyone but billing. They have been sending bills to this old address. Even more frustrating was the information that the medical coverage can deny coverage if the doctor submits the claim more than 6 months after the services. If that happens it is the patient's responsibility to pay the full amount even though you have insurance. My question was how I can protect myself from the idiocy of the billing department. The answer was that I'm supposed to call 30 days after each visit to make sure that all the claims have been submitted. So that's what I was trying to do when they hung up on me. So tomorrow I will be on the phone again trying to make sure they have submitted all the claims to the medical plan. The amount I was given today doesn't sound correct for all the services that were performed so I have a feeling there are a few more claims that need to be filed before that 180 days is up.

Just a heads up to anyone dealing with large medical groups, make sure you cover yourself!


elephantschild said...

Oh, carp. Sorry about the bother. Our dentist did the same thing to us recently. He changed billing software, lost a invoice in the shuffle, and then billed us 60 days late. And he ain't no big medical group either. Just him, his computer, and his pick-chicks!

Presbytera said...

Make certain that no negative comments appear on your credit report since a collection agency was involved.

Sorry for the hassle -- it seems that life is never easy.

Kim said...

Thanks for the suggestion. That was one of the things I asked them right off, we have spent way too much time clearing our credit report over the past 9 years to have something like this mess it up. They said they were a non-reporting agency so it isn't won't show up.

AmusedMomma said...

I dealt with billing hassles with my mother because she turned 65 whle being hospitalized. Before her birthday everything went to one place, after her birthday it went to another. The two insurances were fighting over her actual birthday, and I had one billing clerk who asked me at what time she was born so they could cover it up to that minute. Sheesh! It took 9 months to clear that up between almost daily phone calls and letters and speaking to supervisors. Come to find out almost all the problems came from one office -- the doctor's, whose wife was in charge of billing and really didn't know what she was doing. I really pray your experience isn't as long or hassled!