Standing my Ground; The Insured!

Are you like me? A person that thought having medical insurance would make it easy to get medical service? Well, it is easy, but what is not easy is trusting the billing departments, quasi office policies, or office robotics.

There is a new kind of “taking of advantage” on the insured through billing and the clarity in the service provided by the provider to the insurance and the patient. You either have to know the codes that match the service or carry your insurance phone number on speed dial to quell the issue of the estimated co-pays. I assume most people would say this is quite alright until you see an agreement so extensive, you have to wonder if you should send it to your lawyer first. But I haven’t even mentioned the estimated co-pay and how it differed from the real allowable co-pay.

For most people whether they can afford it or not, there is a huge difference from an allowable of $29 as stated by the insurance representative as opposed to the “estimated $200.00 written in the blank space of an dental provider’s agreement, where the font is so small, no normal person could have time to read at an appointment.

Next, doctors are starting to ask for a credit card to be on file “suggested” they say, but the truth is they have hired people that know very little about the codes to bill the insurance and therefore they are challenged with matching the services like a nurses visit and an vaccination and managing there offices. One doctor said, “Madame, the office is separate from the doctor’s office. I thought this was strange, but I listened. She explained, we charge for the forms because it takes time to fill them out.” I replied, how else will I get the form, are you suggesting I select that it be sent to my email or bring a pack of paper? The doctor said, each form is $10, which is not billable to your insurance.

I feel like calling my next experience, the battle of the breasts. Have you ever known a surcharge, or estimate or office policy to charge $65 upfront for a 3D Breast exam from an insured person, when the exam has been ordered by the doctor, the office has been provided a handout indicating what is covered? The attendant kept saying, this is office policy and its in our contract with your insurance. I asked if it would be deducted from my co-pay and she said I would have to call billing for the answer. Nevertheless, after calling and writing the insurance company, these actions called for the provider to finally read their own contract. I felt like my breasts were being held hostage, not because I didn’t have the money, but because I earned my medical insurance through my retirement. I decided to go else where, but someone decided to read the contract so I finished at the same place. They could have called the insurance company before my appointment, get clarity on the allowable co-pay if they knew the exam that has been ordered. However, I am cancer free!

In short, I admit, I have returned to the United States after an extended time of working overseas, however, I find this behavior quite unacceptable, insensitive and unprofessional. So, for these kinds of practices, I say to the patient, you have the power to move on! (This article are my experiences and my opinions)

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