Insurance question
SweetSyren
member
So I went for my monthly checkup last month as was told that the billing person needed to speak w/ me. She informed me that apparently the pmts I have been making to them each month have not been being applied to my deductible and that I will probably owe them an additional $400 or more after baby is born. I was totally confused (as insurance confuses me in general) and wanted to know where the money was going if it was not being applied to my deductible. She would not answer my question but kept showing me her hand written calculations and saying I could start paying them more now so I didn?t owe as much later. I kept asking her over and over to tell me where the money was going but she kept talking around my question then I got pulled out of there because I had to give blood for my sugar test.
DH is going in today to try and get some answers but I was just wondering if anyone out there understood insurance and what she may have been talking about. When they first told me what my pmt plan would be (back in Dec) I was told that by the time baby came, I would have met or come real close to meeting my deductible, but now she is telling me nothing has been applied to my deductible?????
Re: Insurance question
First, I would insist on seeing a record of all payments made thus far and how they were applied to services received. Hopefully you have a record of how much you have paid so far (I would make my own detailed list at this point).
What is the deductible for? A year of service in general or just maternity services?
If the woman at the office is unable to provide you with answers i would call the 800# on the back of your insurance card and get an agent on the phone. I have had good luck getting explinations out of my company.
FYI - I was told both times I was PG that I had to pay a 500.00 flat fee to have a baby with my doctor's office. My insurance covers 100% of services and there is a 250.00 co-pay for the inpatient hospital stay (this money if actually for the hospital not my doctor's office) at delivery time. I got the policy in hand and refused to pay the 500.00 because I wouldn't owe it to them and I did get it cleared up. My point is...the billing people see so many different insurances you may have to take matters into your own hands so you don't get screwed. GL!!
I agree with Cooley that I would ask for a detailed statement that shows what services were rendered based on the payments that were made. Depending on what type of insurance you have I have had really good luck with the customer service reps. We have Anthem and with having so many complex medical issues in the last 2 years I have had a ton of questions. I've found that when I call the customer service line and talk with a rep they will three-way call the billing center for me (with me on the line). This is SUPER helpful because the insurance rep talks insurance language obviously, they can help explain or refute charges the dr's office is trying to make against you, etc. Plus with you on the line you are able to hear EXACTLY what is said and ask questions as you go.
I've gotten out of paying at least $600 worth of medical bills just by having our insurance reps call the collections people for me-- often medical offices tack on random charges that don't make sense and assume most people will pay (which they do). Plus its much harder for the dr's rep to talk you in circles when you have an experienced insurance rep (who knows your plan) there to advocate for you. I've found the insurance reps don't often offer to do this (3-way call) but every time I've asked they have been more than happy to oblige you just have to give verbal permission to both parties to discuss your private health care info over the phone with each other. GL!