I needed to take some time off work yesterday to go to the DMV to register my new (to me) car so I decided to take a personal day and resolve a new-very old insurance billing issue.
About two weeks ago I received an emailed invoice from a third party medical supplier/billing company (aka CC). I have had two other insurance companies since then so I was shocked by the bill. It was from a date of service in 2011 and I became even more shocked when I saw the amount they were requesting.
Funny side note: It was from this supply order.
I save every EOB and every bill, so I pulled the binders from that benefit year to figure out what was going on.
The more I looked at the amounts paid, the less sense that it made. I had the EOBs, the statements from CC, and the receipts from my payments spread out on my coffee table. I had a spreadsheet where I tried to organize it all pulled up on my computer and I started dialing.
My first call was to Dexcom because they had the greatest number of claims processed that year. I was curious to find out if anyone had actually paid them. That only lasted 10 minutes – mostly because they could only confirm that they got paid, but not what amount they were paid, or how or when it was processed.
My next call was to my insurance company (from 2011 – aka Blue). That phone call was also very short. The first question from the representative was, “why are you calling us instead of CC?” I explained that it was due to the fact that I didn’t want to pay any bills until I had matching EOBs. She said she understood and began clicking through claims. After looking through a few dates of service she put me on hold. The Blue representative came back on the line five minutes later and assured me that all claims had been processed correctly. She instructed me to take up any further questions with CC.
That was the next step. I put together a small snack to boost my stamina and called CC. I definitely needed the extra calories because of all the phone calls, they had the worst automated menu and the absolute worst hold music.
I had researched that insurance companies have a statute of limitations of a year to bill patients for claims so I started with that question. It turns out that third party providers have a year AFTER the insurance company pays in which to bill the customer. The insurance company and the third party supplier had been batting the claim back and forth since 2011. The insurance company only paid the claim in May – there was plenty of time left to bill me.
The rest of the phone call took about an hour but I took some notes on the highlights in case this became another ongoing battle:
- The representative can see payment plan that was set up for my insulin pump but she can’t see the initial invoice because it was so long ago (umm??).
- We “discover” that in the cases where I had a revised EOB, the invoices were not corrected and I was not billed the correct amounts from CC.
- She asked if I had received a refund for the multiple overpayments on my account. I confirmed that I did not but that I suspected the amounts had been reassigned to other invoices because those balances jumped around.
- When I explained to the representative that I was not comfortable paying anything else until the amounts matched she agreed and put me on hold to go over my account “with a fine toothed comb.”
- Did I mention that CC has the absolute worst hold music?
- The CC representative took me off hold twice to say that she ALMOST had the account sorted out and to promise me she was still working on it.
The third time that the CC representative took me off hold she did something that I have never heard before and I am not expecting to ever happen again.
She said to me, “I am so sorry that happened to you. That should not have happened and I will fix it.”
She assured me that I had done everything that CC had ever asked. She reaffirmed that I received bills, disputed the amounts, was assured they were correct, paid the bills, and later was later proven correct, and had the money repeatedly moved around to new (incorrect) invoices.
The 2011 bill arriving three years later will disappear. I have been assured that I do not owe this company another penny. I have a recorded phone conversation, a representative’s name, and a direct extension to support this claim.
I guess I won’t feel confident the bill is actually gone until probably some time in 2017.
And again I am left with the concern about what happens to people who don’t know how, where, or when to fight problems like these. Must read comment from Kelly Rawlings here.