Not my job

Last week I refused to pay over $2,000 in medical bills.

I refused for good reason though, I didn’t actually owe the companies the money they were asking me to pay.

quest billI did have the opportunity to find out that the cost of quarterly lab work when it is not covered by insurance. And it is often NOT covered by insurance if the company hasn’t provided coverage for an individual in over five months at the time of service.

“We will cancel this invoice and reissue a new invoice with the amount you owe.”

(I know they took my insurance card and copied it at the appointment but it looked just like the one before it – same company, different employer, different plan – so they probably didn’t notice it was different.)

At the same time, I received two separate bills from my pump company for service dates about two weeks apart. In late April, I had called them to order pump supplies. At the same time I asked to set up auto-ship. I specifically asked if that would be a problem because I was worried I would mistakenly get a second order once the auto-ship was established that insurance would not cover. I was assured that it wouldn’t be a problem and that if someone tried to process an order it would not go through because they would be able to see the previous order.

I probably was not as surprised as I should have been when I received a box of pump supplies two weeks later. I called the same day and was emailed a shipping label to send the box back. No sooner had that box likely arrived back at the pump company, that I received yet another box with another three months of pump supplies. I didn’t even open the box before calling again, getting another mailing label, and sending another box back.

The rep on that particular call was amused when she noticed that the same person had processed both the second and third shipments. She thought she fixed everything but said we couldn’t be sure until my next scheduled delivery. That’s now actually, and while I have received an email that my supplies are on their way, I haven’t actually seen them yet.

A few weeks after the three boxes arrived in succession, I received a bill for the first shipment. On my current insurance plan, I don’t pay a copay on pump supplies. When I called the insurance company the representative said that there were two ways to process the claim and one would result in a copay and the other would not. I suggested that they run it the other way, and she agreed. End of that bill. Then I started receiving bills for the other two shipments. At first I ignored them because I figured the returns had not finished processing yet.

When I received copies of the bills from the pump company again in late July, I called the insurance company first to see what happened on their side of the process. They tried to help me but (I can only assume) got so buried in the paperwork that they said they would have to call me back. I am still waiting for that call.

Next I called the pump company directly. It was after hours so I left a message with billing and asked to be called back. I waited for a call for a day and then I tried again.

The tl;dr of THAT conversation is that the returns did not make it back to the billing side of my account. In fact, my insurance has paid the pump company for at least one of the returns. I feel like I need to spend another hour on the phone with the insurance company to make sure that they know that they are owed money back, but it’s not my job.

annoying insuranceFor me, that is the most frustrating part of this whole fiasco, and every battle I have to fight with every insurance and diabetes supply company. It’s not my job. It’s not my job to make sure that a single order is not filled three times. It’s not my job to make sure that a claim is not sent to the wrong insurance company. It’s not my job to prove that the insulin I’ve been taking for seven years is still the right insulin for me and shouldn’t be replaced by a different insulin that got a better contract with the insurance company. And on and on.

All those incidents add up, and the time it takes to deal with each one of them affects my ability to have the time to do the tasks that actually are my job. I know I can win most insurance battles so that’s not usually the part I am worried about. For me, the most frustrating part of the whole fight is the minutes and hours lost each time.

6 Comments

  • katy says:

    Ugh. I am sorry this happens.

    I imagine you feel annoyed yet serene and confident during these kinds of tangles because of your excellent binder system.

  • Scott E says:

    Medical billing sucks.

    Just yesterday, I dug up a bill from the bottom of my backpack from my endo’s office where they charged me $71 (not covered by insurance) for “Ambulatory glucose monitoring” (whatever that is). According to the note I scribbled on it in March, I called the billing department and they are going to “look into it”. I haven’t heard anything since.

    It makes me wonder how many errors in billing get PAID by insurance companies, when they are consistent with the patient’s diagnosis but are for services that weren’t actually performed. I’ve seen stuff in the past that didn’t make sense to me (as most of the billing descriptions don’t) but was paid by insurance so I didn’t give it thought. The entire system is broken.

    • Sara says:

      I really hope the $71 was not for a BG check on a meter (the fancy office meter that is SOO different – not!) but I really think it is.

      The other thing it might be is a review of your CGM data. I had that on a bill once for mine. I admit I don’t totally understand the insurance system but if all we did in the appointment was review my CGM, then what is my copay for if you still charge me for everything else separately?!

  • Need A Nap2 says:

    I agree insurance, pharmacy, (pump) company/supplies stuff is so frustrating!! I hope it all gets worked out. It’s interesting how “they’ll get back to you”, but never do. 🙂

  • Marcia C says:

    My type one daughter has just become an adult. While she manages her diesese, I continue to manage the insurance issues that go along with it. Basically, because it just seems like too much. No person should have to deal with both, because both feel like full time jobs some days!

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