OT Hilarious Insurance Payment

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JDS74
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OT Hilarious Insurance Payment

Post by JDS74 » Fri Aug 29, 2014 7:08 pm

We just got an EOB (y'all know what one of those is - right?)
Well for an outpatient surgical procedure, this was the anesthesiologist bill. Pretty ordinary for $800.
So far pretty plain jane stuff.

Well ... They decided to consider $29,000 of the $800 bill and then paid it

I guess I'll have to wait until Tuesday to call and get it straightened out.
BTW, patient responsibility was the usual percentage of the original $800.

I find the whole thing totally hilarious.
No wonder insurance premiums are so high.

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Amenite

Re: OT Hilarious Insurance Payment

Post by Amenite » Fri Aug 29, 2014 7:15 pm

Seems like the whole system is one big scam sometimes. I've been watching these EOBs come through for various things, anywhere from 2 to 20 times the going rate for whatever. If I didn't have coverage I would be totally screwed as it seems they can make up a price and charge it without a word until the bill arrives. If you ever hear anyone mentioning "free market" and "health care costs" in the same sentence, listen very very closely - they may be up to something The two seem to be totally unrelated.

ems
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Re: OT Hilarious Insurance Payment

Post by ems » Fri Aug 29, 2014 7:34 pm

JDS74 wrote:We just got an EOB (y'all know what one of those is - right?

Well ... They decided to consider $29,000 of the $800 bill and then paid it
That's really funny! But considering who you are dealing with...
If only the folks with sawdust for brains were as sweet and obliging and innocent as The Scarecrow! ~a friend~

Janknitz
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Re: OT Hilarious Insurance Payment

Post by Janknitz » Fri Aug 29, 2014 10:32 pm

When my first daughter was born the insurance company OVERPAID the bill by more than $1000! For nearly two years I got threatening letters from the hospital every month that I better pay up the difference, when they OWED the difference to my insurance company. Every month I called the insurer and the hospital and was assured they'd take care of it. I think the hospital ended up with the little windfall. Twenty years ago, $1000 was a lot.
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JDS74
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Re: OT Hilarious Insurance Payment

Post by JDS74 » Sat Aug 30, 2014 6:19 am

BTW: In case I was not clear, the insurance company paid $29,000 for the $800 bill.

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ems
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Re: OT Hilarious Insurance Payment

Post by ems » Sat Aug 30, 2014 9:46 am

JDS74 wrote:BTW: In case I was not clear, the insurance company paid $29,000 for the $800 bill.

Seriously? They actually paid $29,000??
If only the folks with sawdust for brains were as sweet and obliging and innocent as The Scarecrow! ~a friend~

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chunkyfrog
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Re: OT Hilarious Insurance Payment

Post by chunkyfrog » Sat Aug 30, 2014 9:57 am

When they catch their error, I wonder how long they will have to wait for an "adjustment".

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Re: OT Hilarious Insurance Payment

Post by Amenite » Sat Aug 30, 2014 10:00 am

JDS74 wrote:BTW: In case I was not clear, the insurance company paid $29,000 for the $800 bill.
It was clear, I was commenting on the screwed up nature of the system in general. My expectations are low both for providers and insurers based on past experience so I'm not too surprised. But I will say I have been fortunate to have a good experience with my current insurer.

Time magazine published a great article about the US healthcare system, by Steven Brill, Feb 2013 "Bitter Pill: Why Medical Bills Are Killing Us". It lays out the reality pretty thoroughly using real world examples. I found it very interesting. A long read for a magazine article but worth the read IMO.

JDS74
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Re: OT Hilarious Insurance Payment

Post by JDS74 » Tue Sep 02, 2014 6:30 am

Well, I just called the insurance company this morning to inquire about this bill.
They confirmed they really paid the extra $29,000
The person on the phone seemed shocked and indicated they would try to retrieve the money.
Otherwise we seem to have a credit for a lifetime anesthesiology services

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chunkyfrog
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Re: OT Hilarious Insurance Payment

Post by chunkyfrog » Tue Sep 02, 2014 6:42 am


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Pugsy
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Re: OT Hilarious Insurance Payment

Post by Pugsy » Tue Sep 02, 2014 9:24 am

Well there goes the big office Christmas part that the Anesthesiology office was planning in Tahiti.
You are not going to be their most popular patient for telling the insurance company about the over payment. I don't know I would want to be using them again.......

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JDS74
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Re: OT Hilarious Insurance Payment

Post by JDS74 » Tue Sep 02, 2014 10:53 am

Pugsy wrote:Well there goes the big office Christmas part that the Anesthesiology office was planning in Tahiti. .......
Drat!! I should have thunk of that and asked if we could go along, all things considered

Or at least have then spring for a backup ASV for me.

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ems
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Re: OT Hilarious Insurance Payment

Post by ems » Tue Sep 02, 2014 11:18 am

JDS74 wrote:Well, I just called the insurance company this morning to inquire about this bill.
They confirmed they really paid the extra $29,000
The person on the phone seemed shocked and indicated they would try to retrieve the money.
Otherwise we seem to have a credit for a lifetime anesthesiology services
You gotta be kidding (know you're not). The person on the phone seemed shocked.........No!!!!!!!!!!!!!!!!

Actually, why would the insurance company even care about being more careful - they have so much more where that came from.
If only the folks with sawdust for brains were as sweet and obliging and innocent as The Scarecrow! ~a friend~

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sc0ttt
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Re: OT Hilarious Insurance Payment

Post by sc0ttt » Tue Sep 02, 2014 11:42 am

If I were a biller at the surgical center, I'd mess with these guys a bit.

"please resubmit your request and provide specific procedure codes for the services you paid for but that we didn't provide"

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chunkyfrog
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Re: OT Hilarious Insurance Payment

Post by chunkyfrog » Tue Sep 02, 2014 12:00 pm

+100 on not using them again.
A few years ago, I was intubated while still conscious--and feeling it all!
--You bet your booty I bitched!

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