Collections....

Well, no matter how bad things have been in the Great Insurance Wars of 2022, we have hit a new low.

Babygirl hitched a ride to my office a couple of days ago so she could walk to the dialysis center to drop of a box of, well, blood. Not the same as the last one, mind you. A whole different thing.  Or maybe it was dialysate, to make sure the water doesn't have, say, arsenic.  I don't know.

However, she spent half an hour in my office playing with her phone until it was time to go, which was how I happened to overhear The Phone Call.

I could tell that it had something to do with a bill.  After a minute I asked her to put it on speakerphone, which she gratefully did.  To be fair, I missed the caller's identity.  But he was asking for payment of $1600 toward her emergency room physician's bill from 12/31/21.  You know, the day she almost died, what, nearly 15 months ago? 

He was offering to help her set up nifty $25/month payment plan. 

At this point I took the phone.  Apparently only $455 of this bill had been paid by her insurance, so she owed the rest.

Except she DOESN'T.  She has Medicare and Medicaid.  It is illegal for them to sent her a bill for the balance, even if the balance wasn't fully covered. I pointed this out to him, strongly, and let him know I'd be checking with her insurance to see who FUBAR'd what THIS time.  (Maybe that should be DUBAR. I don't know.)

Yesterday I spent 65 minutes on hold with my insurance.  They paid in July, the $455.  They say the bill was resubmitted in September and rejected.  Well.

So I spent half an hour on the phone today with an honestly delightful representative of the ER doctor's billing office.  Turns out they NEVER call, and the bill was in collections. They had my BC/BS listed TWICE, once as BC/BS and once as SmartHealth (the biggest oxymoron in history, but it is our flavor of BC/BS, with the same exact ID#). Once the second BC/BS (same as the first, of course) rejected the bill, they failed to rebill to Medicare and Medicaid.  

She could see where I'd called before, given the correct information, and that the actual patient screen was not updated to match.  Yes, she agreed, it is not only illegal to bill her, but also illegal to send her to collections. 

"Ignore collections, we'll have it rescinded 'after a review.' "

I'm pretty sure she knew what she was talking about. Not so ducking confident about the reviewers.

DeeDee