Wednesday, May 2, 2018

I don't owe $25

Last October I had a doctor visit for a couple prescriptions I was on. My copay for on office visit is $25. The insurance company processed it as $50. Turns out the provider I saw used to work for a specialist office and the insurance company was never updated with her credentials. A phone call back to the dr. office to tell them what the issue was. The billing person tried to tell me to call my insurance company and take care of it. No, your office has to send them proof she no longer works at a specialist. They aren't going to take my word for it! So, she said she called them, got the info on where to fax the info in. In the meantime I'm still getting a statement for the $25. I also called their main billing department (in another state) to let them know what is going on and why I have not paid it.

I get a call from the billing dept. this morning wanting payment. Ok. Listen up. My insurance plan has a $25 copay for primary care providers. Your office I was at is a primary care provider. Your office has not updated the insurance (still, apparently) with the info they need to change the provider from a specialist to a primary care provider. If you want to get paid, then someone from your billing office or the doctor's office needs to take care of this with the insurance company. I looked up the provider on my insurance co website - they still show she works at a neurology office.  The billing dept. person tells me I should call my insurance company again. Fine.

The insurance guy was very nice. He put me on hold (for quite a while) while he called the providers office himself to get the information he needed so they could change the provider to a primary care provider. But, I guess he needed their tax Id# and they didn't have it, and told him to call back in an hour......he's supposed to call me back later and let me know if/when this is resolved.

If this doesn't get resolved this time, I'm calling their billing department and saying LOOK! my contract with my insurance company is for a $25 copay with a primary care provider. I saw one of your primary care providers. If you want to get paid the additional $25 then YOU either get your provider updated with the insurance company or write it off, because I do not owe it and frankly I'm tired of trying to resolve it. If you aren't going to fix this, then I'll have to start seeing a new provider, because I'm not paying $50 copays.

I called my mom to wish her a Happy Birthday. She had just gotten of the phone with my uncle (he's a sweetheart and calls her quite often) and was waiting for her BF to come this afternoon to take her out to eat. I told her about the HepC deal and wanted to know if she knew if she had ever been tested for it. She was born in 1941, so a few years outside the "baby boomer" age, but, since apparently, one of the most common ways to get it is from a blood transfusion, especially back in the 60's or 70's. Well, she had a blood transfusion in 1976. I remember this vividly (I was only 12) because she almost died! complications after having a hysterectomy surgery. Anyhow, she didn't know what HepC is, so I explained it to her and said it probably wouldn't hurt to ask her doctor about it, if she should get tested. She asked me 3 times, "now what does it cause again?" I kept telling her it causes liver damage. "Oh right, I'll need to remember this". She said she's due for a check up soon and will try to remember to ask her doctor about it. She's been telling me for months and months, just about every time I talk to her, that she needs to get in soon for a doctor appointment/check up (because she says it's been "awhile"). Last month I asked her "have you gotten in for a doctor appointment yet?" No, not yet. I need to do that soon."  I guess I'm going to have to start pressing this. Regardless of the HepC thing, she should be going in for regular check ups. I'm sure she must have to go in....she's on several different meds, so she must have to go in once a year to get those refilled, I'd think.


  1. Dealing with doctors offices and insurance is exhausting. I just wish people would do their jobs.
    I'm hoping the HepC turns out to be nothing too serious.
    I actually was tested for it and see the doctor with the results this Friday. I'm not going to stress out about it. What can you do? I figure if nothing regarding HepC has caused me issues before now that I'm aware of, there's nothing to worry about. We'll see.
    Good luck to you & stay on top of your Mom.

    1. Sorry to hear you are dealing with the HepC issue too. I'm not stressing too much. It is what it is and I'm very thankful it can now be cured. I think what's most in the back of my mind is how in the world did I get it? again, most likely will never know. Good luck to you too. Let me know how it goes!