Teri Smith (kitchenqueen) wrote in bad_service,
Teri Smith
kitchenqueen
bad_service

Here we go again with the "great" doctors!

I've complained here before about my now former doctor's office. To refresh your memory, these are the people who who refused to give me a prescription for a needed medication, telling me basically get over it and deal.

I also have just about the WORST insurance in the world. My husband's employer doesn't offer group insurance, but does pay for the plan that we have personally, which is fun to explain to the doctors' offices, since we don't have a "group number" on our cards. That's another story for another day, and I've just accepted that the insurance industry stinks.



I got a statement from them last year, which you practically need a degree in accounting to figure out. They've listed the charges sent to the insurance company, the discount taken by the insurance company, and what the insurance company paid them. Problem is, the amount paid by the insurance company was listed in the column on the statement marked "Patient Responsibility." Yes. They were charging ME what the insurance company ALREADY PAID THEM.

I had a visit to them in February of last year to refill my zoloft. The insurance company denied the claim, since they don't pay for my mental health stuff. (Pre-existing conditions and all.) In the doctor's office's infinite wisdom, they resubmit the claim with a different diagnosis code. I got a call from the insurance company saying that the doctor's office submitted a claim for the first claim with a diagnosis code for anxiety, then submitted the same claim with a diagnosis of stomach pain. Yeah, they call that insurance fraud, people. It's kind of stupid on their part to do that, other than the fact that it's illegal as heck. If the insurance company pays, they get $25.22 for the visit after the discount is taken. I pay my $35 copay, so they get $60.22 for the $115 charge that they submitted to the insurance company. They insurance denies it, and I'm responsible for the whole $115. Yeah, they're not geniuses there.

Another problem with this same date of service? When they resubmitted the fraudulent claim, it went into their system as a second charge. So now, they're trying to charge me $230 for the same date of service.

This is all bad enough, but then I tried to call them to straighten it out. Great idea. /sarcasm

First, the billing person wasn't available and I left a message for him to call me back. Didn't happen.

I called a second time a few days later, in hopes that he would be available this time. Yay, he was. But no, the computer was down and he couldn't help me right now, but he'd call me back when it was back up. During this call, Jason (that's his name) told me that he knew that my account was all screwed up, and to make it up to me, he'd go over my account and give me a "big discount" for my trouble. Yeah, I'm still waiting for that return call.

Saturday, I check my mail. Look, it's a statement from the doctor's office! Jason must have gone over my account and figured it out without calling me back. Let's see how much this "big discount" that Jason promised me was. A big, fat, whopping $0. The statement was for the same amount as the last statement they sent me.

I'm in the process of composing a detailed letter listing their charges, what the insurance has paid them, and what my EoB's say my responsibility is. I know I owe them money, and will gladly pay what I owe them. However, I will not pay them $350 when I know that I don't owe them $350.
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