I am so mad I could scream!!!!!

[JDinNC]

For two months, I have been calling BCBS regarding my deductible. In June, Northside Hospital of Atlanta called to say that I needed to pay off the balance of my deductible which was around $3600. before they would do my surgery. From June through September I figured my deductible was paid since I never received any more medical bills. Then in October, I started to received medical bills again. Twice I talked to BCBS to ask why I was receiving bills again and they told me because I haven't reached my deductible. For some reason, June, July, August and Sept, I had but it seems not now. Last night I was finally able to get on to their website to look at all my claims and could never find that $3600. being listed..

After calling BCBS again, I learned that a lot of providers will ask for money up front to be sure they get paid. Since I had pre-registered a week earlier at the hospital they knew I had insurance but they had all the information. When the hospital called for the payoff of my deductible I really didn't question them but now I know NOT to give providers money up front because the insurance company won't know anything about it.

So I pretty much pissed $3,600. in the wind. So instead of a $ 25,000. Surgery bill, I guess the hospital will be billing my insurance for $21,400.. Though I still do not understand why they said I had reached my deductible in June but not now. So I'm back to trying to get my deductible paid off, I'm now looking at $2,000. In medical bills which I don't have the money.....I would have..if I didn't get taken advantage.

So watch your money and your back..

Jan

[jalusa]

I think the hospital will still submit the full amount to blue cross. They submit the CHARGES not the balance due.

You will end up with a credit balance.

At least I think so.

[JFrog]

It s extremely frustrating. I have to follow every bill and EOB (Explanation of Benefit) closely because I have seen numerous, probably 20% of claims, errors. You need to look at your policy closely for and most importantly look at your EOBs. If you find something wrong, which you will if you have many claims, start off by calling the customer service but most BCBS customer service workers are $9/hr clerical workers looking at a screen to answer your question. For real answers try to get someone higher up the chain either by requesting that on the phone or even better if your insurance is through your employer, get your HR people to help you with their contact person at BCBS. You have to be pushy! As a health care professional myself that does lots of billing I can tell you errors are going to happen because of the enormous complexity of the health care billing industry but personally I have found all the mistakes on my insurance are ones that cost me money, never the other way around.

[Cj51]

During treatment, it was a part time job to keep track of all the bills and the errors. I was, as the above poster advised, PUSHY, and I never accepted an answer that didn't make sense. In the end, they refunded more than $400 in pharmacy charges that had been wrongly billed, as well as a whopping $800 for a "procedure" that didn't take place--I could go on and on. Like you don't have enough to worry about fighting the cancer, you also have to fight with the hospital billing departments and insurance companies. It's disgusting. No advice, just total agreement. I'm sorry you have to deal with this.

Best of luck to you.

Cj

[midlifemom]

I have found providers making errors - often, ones that would cost me.
My process is keeping a simple excel spreadsheet in date of service order based on the eobs. I list date of service, provider, amt billed, paid by insurance and my responsibility according to the eob. This way, when I get provider Bill I can verify if it agrees with what ins co told me. I then record my payment with check number.
This has helped me numerous times to avoid paying what the provider erroneously told me I owed. Also helpful with taxes.

[lhawk0730]

Jan, do you have anyone you could delegate this to? I only ask because its stressful and time consuming. I know I would absolutely be willing to do something like this for a sick friend. I took on medical appointments, referrals, insurance coverage, etc for mom. Not because she isn't capable, but because I didn't want her to have to deal with the headache of it. Is there anyone else you could hand this over to so you can simply focus on your health?

[Nik Colon]

Get a printout of all you have paid out of pocket and send to them. They always include it in my bill so I don't understand why ins didn't know. I have bcbs and never any issues. Anyway. As I mentioned, get a printout of your yearly pmts made from wherever you went. Some copay may not be included, some may, ask your ins, but anything above that should. Ask details if copays are included in your deductable. I still have some bills now and then even tho my deductible is met. Everything above copay is paid, but I still have to pay the copay. Stupid I know, but it is what it is. It's usually for gp and other odd stuff but not my hospital bills. (I believe)

[PGLGreg]

... but most BCBS customer service workers are $9/hr clerical workers looking at a screen to answer your question.

BCBS is an association of insurance companies, and some may give better service than this. I never had problems with my local BCBS insurer here in Hawaii.

[cathy123]

I always check insurance eobs also, numerous times I have found mistakes in the hospital bills. They aren't even surprised when I call, just say ok I will reprocess. Except for during transitions from one insurance to another I have not found any issues with the numbers from the insurance companies. I agree - it is a lot of work to keep track of!

[JDinNC]

Jan, do you have anyone you could delegate this to? I only ask because its stressful and time consuming. I know I would absolutely be willing to do something like this for a sick friend. I took on medical appointments, referrals, insurance coverage, etc for mom. Not because she isn't capable, but because I didn't want her to have to deal with the headache of it. Is there anyone else you could hand this over to so you can simply focus on your health?

I have always been the one who took care of our finances/ phone calls/ bills/ taxes/ everything...I know how to deal with this kind of stuff....but this is the first year of total confusion with BCBS.


What makes me the most angry....all of this is caused by the errors of BCBS. I keep track of all my bills that I pay by matching them up with the EOB. I had reached my deductible by June, where at that point all my medical bills were paid through the summer. I had genetic testing done, BCBS was bIlled, BCBS personal sent me a cHeck for over $7,000., that same week, BCBS sent a letter stating they wouldn't pay for the testing, here I am hold a check for a test they refused to pay, I sent the check back to them, since then, I'm told I haven't reached my deductible..that was in Sept.. I have called BCBS 4 times since Sept. and nobody can explain what's going on. Plus because I have all my treatments done in another state....I live in N.C. but go to Ga. They tell me I have to talk to BCBS/Ga., but they can't help me because they can't excess my policy...it's a vicious circle. I tried to view my claims on line...and the download just kept spinning for two days.....my question?...how did my deductible drop from being paid to not being paid ??????

[lhawk0730]

Hi Jan, I never meant to imply you weren't totally competent, or not the best person to be handling this. I was only asking if you had someone you could hand the stress and irritation of this off to. Sounds like you have a solid handle on it. Just wanted to retract any insinuation you needed help and jump on the well traveled, and fully justified, bandwagon of empathy in dealing with insurance companies. Keep at it, as others recommended, and I hear your frustration!

[Nik Colon]

Jan, do you have anyone you could delegate this to? I only ask because its stressful and time consuming. I know I would absolutely be willing to do something like this for a sick friend. I took on medical appointments, referrals, insurance coverage, etc for mom. Not because she isn't capable, but because I didn't want her to have to deal with the headache of it. Is there anyone else you could hand this over to so you can simply focus on your health?

I have always been the one who took care of our finances/ phone calls/ bills/ taxes/ everything...I know how to deal with this kind of stuff....but this is the first year of total confusion with BCBS.


What makes me the most angry....all of this is caused by the errors of BCBS. I keep track of all my bills that I pay by matching them up with the EOB. I had reached my deductible by June, where at that point all my medical bills were paid through the summer. I had genetic testing done, BCBS was bIlled, BCBS personal sent me a cHeck for over $7,000., that same week, BCBS sent a letter stating they wouldn't pay for the testing, here I am hold a check for a test they refused to pay, I sent the check back to them, since then, I'm told I haven't reached my deductible..that was in Sept.. I have called BCBS 4 times since Sept. and nobody can explain what's going on. Plus because I have all my treatments done in another state....I live in N.C. but go to Ga. They tell me I have to talk to BCBS/Ga., but they can't help me because they can't excess my policy...it's a vicious circle. I tried to view my claims on line...and the download just kept spinning for two days.....my question?...how did my deductible drop from being paid to not being paid ??????

Where or who did you get the original info that it was paid? Do you have any paperwork or a name who gave you this info? Is there a way you can find out?

[JDinNC]

Hi Jan, I never meant to imply you weren't totally competent, or not the best person to be handling this. I was only asking if you had someone you could hand the stress and irritation of this off to. Sounds like you have a solid handle on it. Just wanted to retract any insinuation you needed help and jump on the well traveled, and fully justified, bandwagon of empathy in dealing with insurance companies. Keep at it, as others recommended, and I hear your frustration!

I know you didn't mean anything by your statement....I try to get my husband To make these calls but trying to explain the problem to him is more frustrating then just talking to BCBS myself. He's really going to wish he paid more attention to this stuff if anything does happen to me.

[JDinNC]

Jan, do you have anyone you could delegate this to? I only ask because its stressful and time consuming. I know I would absolutely be willing to do something like this for a sick friend. I took on medical appointments, referrals, insurance coverage, etc for mom. Not because she isn't capable, but because I didn't want her to have to deal with the headache of it. Is there anyone else you could hand this over to so you can simply focus on your health?

I have always been the one who took care of our finances/ phone calls/ bills/ taxes/ everything...I know how to deal with this kind of stuff....but this is the first year of total confusion with BCBS.


What makes me the most angry....all of this is caused by the errors of BCBS. I keep track of all my bills that I pay by matching them up with the EOB. I had reached my deductible by June, where at that point all my medical bills were paid through the summer. I had genetic testing done, BCBS was bIlled, BCBS personal sent me a cHeck for over $7,000., that same week, BCBS sent a letter stating they wouldn't pay for the testing, here I am hold a check for a test they refused to pay, I sent the check back to them, since then, I'm told I haven't reached my deductible..that was in Sept.. I have called BCBS 4 times since Sept. and nobody can explain what's going on. Plus because I have all my treatments done in another state....I live in N.C. but go to Ga. They tell me I have to talk to BCBS/Ga., but they can't help me because they can't excess my policy...it's a vicious circle. I tried to view my claims on line...and the download just kept spinning for two days.....my question?...how did my deductible drop from being paid to not being paid ??????

Where or who did you get the original info that it was paid? Do you have any paperwork or a name who gave you this info? Is there a way you can find out?

First phone call, she told me I had reached my deductible.

second phone call, was about the check from genetic testing, BCBS/NC connected me with BCBS/Ga., she couldn't help me but stayed with me on a three way call trying to find the right person to help me. It took three hours, yes three hours. Her name was Katina and was so helpful

Third phone call, was about why I now hadn't reached my deductible. I wanted to know what caused this. No one could answer this question..some lame excuse that BCBS could change its mind if they felt they paid to much. This person give me a reference number used for a request to get a explaination on my change of deductible.

Forth phone call today, was to get the follow up information from the reference number but there wasn't any. And to learn about being ripped off by the hospital of $3600.

Just think my calendar year ends in December and now I'll have this year bills and a new deductible bills to pay next year.
2016 will be my last year before Medicare starts hope its better

[midlifemom]

Hi Jan, I never meant to imply you weren't totally competent, or not the best person to be handling this. I was only asking if you had someone you could hand the stress and irritation of this off to. Sounds like you have a solid handle on it. Just wanted to retract any insinuation you needed help and jump on the well traveled, and fully justified, bandwagon of empathy in dealing with insurance companies. Keep at it, as others recommended, and I hear your frustration!

I know you didn't mean anything by your statement....I try to get my husband To make these calls but trying to explain the problem to him is more frustrating then just talking to BCBS myself. He's really going to wish he paid more attention to this stuff if anything does happen to me.

Jan,
I hear you about being the one who understands and handles things and what is DH going to do when I'm no longer around or capable of handling it. Luckily, my dh agreed that he had to learn about all this stuff. So, I collect all the eobs that arrive in one week and one night during the week we review them and I put them in my excel sheet. We did this for maybe 10 times. Unfortunately, big problems, such as you're going thru now, it is easier not to delegate. Butt by teaching our dh's now, they will eventually be able to handle the big stuff (I hope). Best of luck.