Wellness

[KimmC]

More and more often.  Example...Emergency services not covered for my son..hospital said they don't participate with my insurance..even though my ins co said they would pay for it.  Been going on since March..both blaming the other...but bills keep coming!

[151949]

I kept getting charged for having blood work done - up to $60 total this year - when my DH who has the exact same ins, doctor and lab doesn't get charged. I tried to fight it tono avail - then out of the clear about a month ago I received a refund check for $54. It will be interesting what happens the next time I get blood drawn.

[Meowingkitty]

My husband had a colonoscopy earlier this year and it's supposed to be paid 100%. Got a bill and immediately called the doctor. They billed it wrong and it should have been billed as preventative. The rebilled it and problem solved.

[Ms X]

I've been denied coverage for what I knew were covered services a few times.  When I call the insurer, they tell me they don't like the code the practice used.  I call the practice's billing department and it is covered.  Always call and ask because it might be just some kind of error or misunderstanding.

[151949]

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@Meowingkitty wrote:

My husband had a colonoscopy earlier this year and it's supposed to be paid 100%. Got a bill and immediately called the doctor. They billed it wrong and it should have been billed as preventative. The rebilled it and problem solved.

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My insurance if you have just the screening colonscopy it is paid 100% but if they snip off any polps it becomes an outpatient surgical procedure and now you have to pay 20%. Could possibly cost hundreds of dollars.

[DiAnne]

I keep getting refund checks from my insurance with no explanation.  This has been going on for a couple of years for all different amounts from $14 to the one I got last week for $147.  I have been in good health and haven't paid more than $50 out of pocket.  

[SahmIam]

No. What baffles me are the costs of Rx; it's supposed to be $5, $15 and $35 at this point (or free in some cases). So why is it $28 or $47 or $8 or some other bizarre amount?

[Winkk]

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@Meowingkitty wrote:

My husband had a colonoscopy earlier this year and it's supposed to be paid 100%. Got a bill and immediately called the doctor. They billed it wrong and it should have been billed as preventative. The rebilled it and problem solved.

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This happened to my daughter on a mammogram.  Routine is covered 100%, but they billed it medical and they said she had to pay. It's all in the coding.  Took several phone calls to straighten it out.

[151949]

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@SahmIam wrote:

No. What baffles me are the costs of Rx; it's supposed to be $5, $15 and $35 at this point (or free in some cases). So why is it $28 or $47 or $8 or some other bizarre amount?

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I always wonder this too - where do they come up with these numbers? My tier 1 has a $2 co pay so a 90 day supply should be a $6 copay. It is indeed a rare occurance that I go to get my all teir 1 drugs that they only charge me $6. Then you have to stand there and argue with them and the people behind you get restless etc. They think we are too stupid to know they are ripping us off.