At 10:30 this morning I received a phone call from the hospital. The receptionist informed me that my insurance company denied coverage for an upcoming procedure. The procedure was scheduled only three hours later at 1:30 in the afternoon. In order to be seen I had to authorize direct billing. If I didn’t agree my appointment would be canceled. What choice did I have? I agreed to pay out of pocket.
I figured I had three hours to get the problem resolved with my insurance company. My husband contacted the insurance company as soon as I hung up the phone. Two hours later after speaking with 5 different insurance representatives and the doctor’s office at least 5 times we believed the issue had been resolved. That is until I attempted to check-in.
When we arrived we found out that the manager, who is the only one who can authorize billing decisions had already left for the day and that no one else in the entire hospital could authorize the claim to our insurance company. We were rudely told to go back to the first floor to pay the cashier $500. We were not told why we needed to pay that amount or what that amount covered.
When we arrived downstairs the cashier didn’t understand why we had been told to pay $500. She said we had a $100 hospital copay. Nothing more. The cashier was extremely helpful and truly tried to help us resolve the issue. She informed us to go back to the receptionist and inform her that we were cleared for the procedure. But when we returned to the receptionist she refused to hear what we had to say, despite the fact that we handed her the business card of the cashier and urged her to call for confirmation. She informed us that we had to pay $500 to the cashier and $500 to the doctor performing the procedure or our appointment would be canceled.
At this point we had been going back and forth between the receptionist and the cashier for 50 minutes, in addition to the original two hours of calls to the insurance company, and my appointment was fast approaching. My husband wanted to walk away. He wanted to reschedule for a different day, even though the soonest appointment was a month away, so that we could resolve the billing issue prior to the procedure. But I stubbornly had my mind made up that the procedure would be completed today. So he begrudgingly went with me to pay the cashier.
We paid $1000 out of pocket. I was later informed that $1000 was the minimum payment, although I still don’t know what I paid for, and to expect a larger bill sometime in the future. But the chaos didn’t end there. After talking with the doctor I was informed that a CT scan, which is a vital part of the procedure, had not been ordered. Since the initial part of the procedure was not covered by insurance it seems the CT scan would not be covered either. My husband was later informed that the scan will cost us at least $1700. That’s just for the CT itself, who knows what the doctor and technician fees with be.
If anyone has gone through a fight with doctors and insurance companies before I would love to hear your thoughts. I am going to try to call both parties tomorrow to get the issue resolved.