So back in January I had to rush David to the ER with chest pain…anyone remember all of that? Spent half a night there…I remember it quite vividly but who wouldn’t you know?
We got bills of course..however with everything being filed on his insurance I kept holding out paying stuff.. We had got a bill for around 3000 and then finally I was getting one for 700 so my dumb self figured that was what the 20% + his deductible and ER visit fee was…and that everything was filed and settled. Because it would have added up pretty close to that…
We went ahead and set up payment on that portion of what I thought was THE BILL…because it came with a note that they were going to turn it over to collections within 10 days of the letter..Anyways..Really friendly folk at the hospital. 30 bucks a month. Thought it was a done deal.
Then today I got a bill for 3000 again..and I was like O.K. what is going on?
I called the hospital who explained to me (even though I wasn’t him..this becomes an issue in a minute) that in fact there were 2 seperate bills and that for some reason his insurance had denied the claim. She actually told me it ws because his insurance tried to come up with it being a prexisting conditon!
I was like whoaaaa back up the truck. David is 26 and other than having a rash and earache back in 2010 he has NEVER been the Dr for anything…and that was just minute clinic! She also told me that if I couldn’t get it taken care of within the 6 month guideline that we would have to pay in full the WHOLE amount (7/25 is 6 months).
Anyways, this gal was very friendly and frankly you could tell they were just as baffled by it as I was! She suggested I cal the insurance and go from there and have it refiled.
Girl at the insurance office 1800 was a royal B word..she kept going off on hippa regulations and whatnot. Hello. The HOSPITAL told me what was going on..Plus i’m his wife. Plus..well anyways it irritated me..I mean if david came home to a 3000 bill i’d be taking him back to the ER. It wasn’t like I was trying to find out anything I didn’t already know. I just wanted them to REFILE THE FREAKING CLAIM. It was quite hillarious when I told the girl I already knew that the reason that they hadn’t paid cause they were hollering prexisting and she wouldn’t budge. I was like sweetie I ALREADY KNOW you aren’t keeping anything a secret! SHEESH
I called the hospital back and talked to another sweet gal, who told me that they couldn’t refile it on their end and it would have to be done through the insurance. She also told me to get a little more aggressive and see if I couldn’t get something done.I was like I can’t believe they don’t have it on file that he had no symptoms of this beforehand when they asked him every 5 minutes too! it just was baffling!
I called the secratary at david (and dad’s ) work(Peggy) and she gave me the local number to the girl that does their insurance work..Her name is Kay. Another sweet girl. As soon as she looked at David’s account she told me that she knew exactly what was going on. It was because David didn’t have any previous insurance/ primary physician listed, and no medical information given when he signed up with the insurance in November.
I told her that was correct, that david didn’t have any of that at all. She explained to me that because it was something heart related and not just a virus, and he had only been under coverage about 3 months that it raised all these red flags and stuff, and that I should have gotten a letter or notice with more information being requested which I never did..
She told me she would get the proper paperwork sent to me and she would contact me back in a little while. IT was going to be a mess because we had to find out who the ER dr was, and try to get up with the ER dr to get a note that specifially stated david hadn’t had any of these issues 6 months prior to insurance going into effect.
No less than 15 min later she called me back with some VERY awesome and unexpected news..Peggy basically gave a sworn statement that David had not experienced these problems before..She would know because David has worked there for the last 4 years and so on and so forth. I was in shock! This way the claim can be released and refiled…Also she said it looked like the claim was eligable for discounts + would cover the 80% so we would only be responsible for what I was originally expecting.
Also, I should be able to call about the 700 bill and have it refiled as well! then everything can get combined and we can make one payment! If i have done my math correctly we should come out a few hundred bucks to the better too!
Keep your fingers crossed for me ..I have to explain this simply to david when he gets home lol.Ack>:)