Rant: re clinic is still billing us 4 months later

ladyteach0505 · November 2014

We paid our final IVF bill months ago and my last treatment from them was actually an ultrasound for pregnancy (which Should be covered by my insurance) and yet my insurance is denying everything coming out of the office pregnancy related and this doctor is in network. It's literally another 1,000 bucks.

No one prepared me for all of the hidden costs of fertility treatment. This is just insane...

I'm going to try to fight it, but I've never argued with insurance and won.

weansworld09 · November 2014

That's awful

an extra $1,000 is no joke and I hope you're able to work something out with your insurance company.

southernyankeegirl · November 2014

I hate fighting insurance, but if you are justified, it's worth it!!! Work with your REs billing people and the insurance company in tandem. It might be the doctor didn't file something properly, or needs a letter of explanation. Get a copy of your benefits and highlight the relevant parts and send a copy back to them.

Good luck!

Neesey · November 2014

I'd call the RE's office. Make sure it was coded correctly, they actually billed your insurance...... Then call your insurance company too to get more details about why they denied the claim.

pblge · November 2014

Start with your insurance company to find out why they're not covering it. I had two OB claims denied recently. The first was because the doctor had billed it as though I was not present for the test. Hilarious, given that it was a pap smear. The second was because they hadn't indicated what room I was in for the procedure. Both were covered as usual as soon as this was cleared up.

I also got a bill for blood tests recently which should have been covered with a small copay. The odd part of this was that it was from my RE--recall that I traveled for this last IVF--and I wasn't even in that city during the whole MONTH for which these tests had supposedly taken place. When I called, they realized it was an error and removed it.

This stuff is definitely annoying, not least because it means you have to spend a lot of time on hold. But if they should be covering it, keep calling! Sorry you're dealing with this.

ladyteach0505 · November 2014

Thanks! I called insurance and apparently my RE keeps billing pregnancy as infertility. It's so frustrating.

southernyankeegirl · November 2014

ladyteach0505 said:

Thanks! I called insurance and apparently my RE keeps billing pregnancy as infertility. It's so frustrating.

Call your RE and tell them that. Tell them that if they re-code it as pregnancy, it will be covered. If they insist on billing under infertility, then they're not going to get paid.

I have sadly found that some doctors offices and hospitals prefer to just accept a rejection letter from an insurance company and go after the patient because the amount they can bill the patient is usually several times greater than what their agreed rate is with the insurance company.

I fought a $165 bill for my third beta blood test to confirm pregnancy for a loooong time. Apparently if it had been covered, my insurance would only have paid $13. But since they rejected the claim, the hospital felt they could just charge me the full amount (which sometimes they can, but my insurance had denied it as "Patient Responsibility: $0" which the hospital just chose to ignore and tried to bill me anyway). I had to threaten to report the hospital to the Better Business Bureau AND file a complaint with my insurance company for predatory billing unless they stopped harrassing me about a bill that was not my responsibility.

ladyteach0505 · November 2014

Yes! It is 80 insurance vs 350 me for a single claim they've filed. It's ridiculous!

AMShark · November 2014

It is definitely worth fighting. Several years ago, when my father had a heart attack, my mother argued with the insurance company for months over his ambulance transport from a local hospital to a hospital with a cardiac unit. They said my mother should have driven him. My father actually had his heart attack immediately after entering the 2nd hospital (while waiting for testing), and by the time my mother arrived behind him, they were already prepping him for surgery. Nice call, insurance company. Thanks for trying to kill my Dad.

She eventually got it resolved. I also spent many hours on the phone between the insurance and the hospital over coverage for a prescription. (He'd had an allergic reaction to the medicine the insurance company wanted to cover, so the doctors had prescribed a more expensive alternative). But after several days of many phone calls, I got it straightened out. (In a fun twist, he had an allergic reaction to the new medicine too & it was all for naught... but whatever).

My point is, if it should be covered by insurance, even if they tell you its a "gray area," just keep at it until you can get it fixed. Sometimes, you just get the wrong customer rep on the phone the first time, but on your next call, you get the person who actually knows how to help you.

Good luck.

ETA - just another thought - If you can share the burden of insurance company pestering with someone else (like your OH) don't be afraid to ask for help. My mother and I took a divide and conquer approach, and we took turns getting placed on hold.

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Rant: re clinic is still billing us 4 months later

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