Community› The Bump Month Clubs› October 2015 Moms
October 2015 Moms
New Discussion

Insurance - Stressed

JaqiDec04JaqiDec04 member
in October 2015 Moms
I have a doctors appointment tomorrow where I'm afraid I will have to argue with my doctors office over insurance and how they are billing me.

They want to bill me at labor for everything, including all my prenatal visits, which will mean deductible + my coinsurance (roughly $2200). However, all my prenatal appointments are covered 100% by my insurance. But if they don't bill my insurance for it, then I have to basically pay for them all "cash" since they'll be under my deductible. I'm kind of wondering why I need the dumb insurance at this point.

I really don't understand why they want to do this. Or why I should pre-pay for services I haven't received yet. My insurance company says I don't have to, but I guess it'll be up to my doctors office wether they will continue to see me.

Anyone else deal with this? I just want my prenatal visits billed separately from my labor & delivery. That's what insurance is for.
BabyFruit Ticker
Baby Birthday Ticker Ticker
Report Reply to Post

Re: Insurance - Stressed

  • OliveOyl2014OliveOyl2014 member
    My doctor does it the same way. They call it global billing. They take everything and bill it at the very end. The only thing that was separate was the anatomy scan. We ended up having to pay most of the deductible prior to getting the scan done, then we just paid the 20% at the end.
    Report Reply
  • Loading the player...
  • JaqiDec04JaqiDec04 member
    @oliveoyl2014 - i realize some do, and maybe it doesn't matter to some, but my insurance covers prenatal visits 100%, which is nearly half of that bill if not more, so it doesn't seem right I'm paying that out of pocket when my insurance covers it, just because of the way they want to bill it to make it easier on them.

    I'm going to talk to them tomorrow. Hopefully we can work something out.
    BabyFruit Ticker
    Baby Birthday Ticker Ticker
    Report Reply
  • KristyhanaKristyhana member
    That does sound weird. My OB gave me an estimate of what I'll have to pay for the office visits and that it'll be due within 30 days of delivery or something like that. But it didn't include the hospital/delivery part because I'm pretty sure that part is going to cost me around $2000 or so and the office visit bill was only around $400.
    Report Reply
  • JaqiDec04JaqiDec04 member
    Kristyhana said:
    That does sound weird. My OB gave me an estimate of what I'll have to pay for the office visits and that it'll be due within 30 days of delivery or something like that. But it didn't include the hospital/delivery part because I'm pretty sure that part is going to cost me around $2000 or so and the office visit bill was only around $400.
    This is what I'm hoping for. To split them up. I know in the end, I'll have to meet the $2000 deductible no matter what, so its not an avoidance thing. I'm not going to prepay for services. I'm saving up the money to meet the $2000, but I'm not going to prepay that to a doctors office when they haven't even billed my insurance yet.

    Basically, I don't trust them to bill me correctly or give me money back.
    BabyFruit Ticker
    Baby Birthday Ticker Ticker
    Report Reply
  • rosebby7rosebby7 member
    edited May 2015
    My insurance pays for 100% or prenatal visits but they make me pay a $25 co-pay every visit that they put towards my delivery, I think it's actually pretty cool.
    Report Reply
  • JaqiDec04JaqiDec04 member
    rosebby7 said:
    My insurance pays for 100% or prenatal visits but they make me pay a $25 co-pay every visit that they put towards my delivery, I think it's actually pretty cool.
    This is exactly what i have. I'd actually like to use the insurance that is costing me a fortune.

    I absolutely love that hubby is self employed, its such a blessing. But insurance SUCKS
    BabyFruit Ticker
    Baby Birthday Ticker Ticker
    Report Reply
  • Kmohney1Kmohney1 member
    If it makes you feel any better, I just got a $1200 bill for my nt scan (On top of the $1600 I'm paying for my appointments and delivery). I called my insurance and they said they could possibly bring it down but to talk to my hospital. It was the hospital that told me it was covered by my insurance! Why I have to hold people's hands through their jobs, is beyond me. Pregnancy rage in full effect today!
    Report Reply
  • OliveOyl2014OliveOyl2014 member
    JaqiDec04 said:

    @oliveoyl2014 - i realize some do, and maybe it doesn't matter to some, but my insurance covers prenatal visits 100%, which is nearly half of that bill if not more, so it doesn't seem right I'm paying that out of pocket when my insurance covers it, just because of the way they want to bill it to make it easier on them.


    I'm going to talk to them tomorrow. Hopefully we can work something out.
    Same here- the prenatal visits were still covered 100%. They just chose to bill everything at the end instead of each visit. What we ended up owing at the end was majority labor and delivery costs plus a few random lab tests that weren't covered. I had to call to get clarification because I thought the same thing you did, that I would end up paying for the prenatal visits also.
    Report Reply
  • cgummiecgummie member
    My office me asked me to do this, too. And you absolutely do not have to. As long as you're paying for each visit as the bill comes in, you shouldn't encounter any issues. My insurance company advised against paying it "globally", probably because its easier for them to bill per visit. It makes it much easier to see that they were trying to overcharge me.
    Report Reply
  • ameares721ameares721 member
    My visits are covered 100% but not all testing/procedures are covered 100%. My deductible is $700 so I pay $200/month to my OBGYN who is linked with the hospital I plan to deliver at so by the time I deliver, I will have met my deductible. My hospital bill should be less than $1000 which was the goal!
    Report Reply
  • double2roubledouble2rouble member
    I still have flash backs to calling the insurance company after my daughter was born.  Every single bill seemed to be either wrong or the person filling it didn't send it to insurance first and just sent it to me.  This time we are high deductable so we will be paying a lot no matter what. 

      
    Report Reply
  • Krysta6Krysta6 member
    It's all so confusing! My OB requires we pay most in advance ($3650 deductible) so I'm paying large payments every month. But what really terrifies me is if the hospital beats my Dr to billing the insurance then I will have to pay the hospital as well and my OB will refund the money (since I'm paying but they aren't billing yet I'm out twice as much money for a while!) I wonder how long it will take to get my money back if the hospital bills first!
    Report Reply
  • jenspeakejenspeake member
    I'm interested if anyone need the MaterniT21 test and if you got your bill back from Sequonom and want it ended up being.  Mine was $900.  I work in insurance and our claims manager said that they aren't coding it correctly and that is why the final bill is so high.  She gave the benefit they should be using so I'm going to call them and see what they say.  Just interested in other's experiences so far.
    image


    Report Reply
Sign In or Register to comment.
Choose Another Board
Search Boards
"
"