by Ashley
Don’t you just HATE dealing with insurance companies? It feels like you always get the runaround and then nothing is resolved in the end! Ugh!!
Well I (unexpectedly) actually had a positive experience this past week!
I had two separate issues I needed to speak with a representative about.
- Mayo Clinic bill
- Prescription Reimbursement
Regarding the former (Mayo Clinic). We all remember how we owe the Mayo Clinic money for services rendered to Chris when he had his mystery illness at the end of 2013. Well, even though Mayo Clinic is out-of-network for us, our insurance pays a flat rate of $100 toward the service. To have this happen, Mayo Clinic must send a bill to our insurance (Blue Cross Blue Shield of Arizona), then BCBS sends ME a check for $100 and a statement of benefits. I then send payment and the statement of benefits on to Mayo Clinic and set up a payment plan for the remaining balance owed.
I have had a HELL of a time getting BCBS to send me this information. Every time I call they say they haven’t received anything from Mayo Clinic. I call the Mayo Clinic and they cite exact dates they sent the information; verify address, fax number, etc. Everything is correct.
So after receiving yet another bill from Mayo Clinic (we are 4 months past due at this point), I call BCBS and – shocker! – they say they have not received a bill from Mayo. Exasperated, I explain my situation: This bill is becoming delinquent, I can’t set up a payment plan until they get the information from you, they say they’ve sent the information multiple times, etc. What do I do????
Unlike in the past, where I’m told simply to call Mayo Clinic and tell them to re-send the bill (for the umpteenth time), this time the representative put me on hold and called Mayo Clinic personally!!! When he came back, he explained the problem (they had included the subscriber number, but not the group number, so it was never “matched up” to us in the BCBS system). They rectified the problem and are getting everything processed immediately. YESSSSS!!!!!!! One step closer to actually being able to set up a payment plan and start working on that debt!!!
In reference to issue #2 (prescription reimbursement). When we went back to Texas for Christmas, I had accidentally left my prescription for birth control in Arizona (a little personal, but relevant since it was not a prescription I could “do without”). I was NOT about to mess up my cycle, risk getting knocked up, etc., so when we arrived in Texas I promptly called in a refill and paid out-of-pocket to get it. I had to pay out-of-pocket because I was refilling it before it was time, but I was told I’d be reimbursed by insurance because I wouldn’t need to refill it the following month (once I returned to Arizona I obviously still had the prescription there, so I had more than enough).
So I sent in my receipt and the appropriate paperwork back in February to be reimbursed. And just this last week I got a letter denying my reimbursement with the explanation “75% of medication must be used before a refill can be processed.”
So I explained the situation to the BCBS representative and asked if anything could be done, or if this was the final word. He was so kind to explain that “YES! You can definitely challenge that letter!” and he even told me basically word-for-word what to write in the letter, and where to send it!
Now, there’s always the possibility that BCBS denies my request again (insurance companies never make it easy, do they?), but I was so happy and pleased with the service I was given by this particular representative. Wooo!
So, fingers crossed I get the check from BCBS for Mayo Clinic AND I get reimbursed ($55.99) for a prescription I filled way back in December!
I’m fighting the good fight. It’s time versus money over here, and my $100 for Mayo Clinic and $55.99 for a prescription feels like a LOT of money right now…..and at this point I guess I have more time than money, so its worth it! : )
Hi, I’m Ashley! Arizonan on paper, Texan at heart. Lover of running, blogging, and all things cheeeeese. Freshly 40, married mother of two, working in academia. Trying to finally (finally!) pay off that ridiculous 6-digit student loan debt!
That is great! Persistence pays off in dealing with finding what went wrong with claims, payments, etc. and you are learning more about what questions to ask and requests to make.
Love the last line about having more time than money right now…our insurance company was giving us a 500 dollar deduction in premium over the course of the year if we went and got a physical with our GP and faxed in the results. Other co-workers didn’t want to take the time to do that, but 500 dollars for 1-2 hours. I’LL TAKE IT.
Good luck with the insurance companies….I feel the same way about calling Sallie Mae. It all depends on who you get on the phone, and I’m glad you got someone helpful!
This is more to the blog owners than this post – Is there a way to maybe add a page or a graph or something to show the change in debt of all the bloggers over time? Maybe add it in their signature or create a “debt tracker page”.
As a reader, I’d like to get a sense of how they are progressing over time and right now i think just the very first post lays that out.
This is a great idea! I’d love to see it too. It’s motivating!
I know Jeffrey said they were working on making a side bar graphic for each of us (like what all the previous bloggers have had, but there would be 4 since there are 4 of us now). In the meantime, I could make a page with just my personal debt updates if it helps to see. I know its annoying to have to click through posts to try to find it and its often relevant to whatever is being discussed.
While you’re dealing with the insurance companies, watch your actual medical bills just a closely. Ask for itemized statements and, if nothing else, make sure to verify the admit and discharge dates and ask questions when you don’t understand a charge. Keystroke errors can occur and you don’t want to be paying for procedures you didn’t receive!
Ugh, seriously! This hasn’t been a problem with the Mayo Clinic, but there’s a hospital that has sent us about 8 different bills (same account number) all for different amounts. I thought it was surely some mistake but when I called up there, they say its the same account # because its for the same individual, but the bills are all separated by dates of service. WTH??? Makes no sense! I told them I wouldn’t pay anything else until I get an itemized receipt of ALL services. It feels very shady because I’ve been sending checks the past few months and they aren’t being reflected in the bills…..and then I find out there are multiple bills??? I’m still a little worried about being credited for the money we’ve already paid. I have learned that there’s a not-for-profit hospital in Tucson and they have been AWESOME!!! But unfortunately most of the services were from a for-profit hospital and it honestly feels like dealing with a shady used car dealership or something. I hate to say that about healthcare, but its true. I’ve called twice now to ask for an itemized bill and still haven’t received anything and I’m adamant about not making another payment until then, so we’ll see how that shakes out… : /
Ugh I feel your pain. Insurance companies are the worst thing in the world to deal with. I’d rather try to negotiate with an enemy, then one of them. You have no idea how many times these companies have reduced me to tears of frustration trying to deal with them.
I swear they make it so terrible to deal with so that you will just give up and foot all the bills yourself!
I am glad you have had some positive results , you deserved it with your persistence. 🙂