| When you have an issue with your health | | | | company, this is what I found out (another |
| insurance company and you think you've been | | | | unfortunate aspect of these things-most |
| billed incorrectly, it can sometimes be a very long | | | | situations do involve a little "digging"). My insurance |
| road to get some results for yourself. | | | | company says that I have a $500 deductible with |
| However, it can be done, you just need to know | | | | them with regards to emergency room visits and |
| how to do it. Utilizing concepts such as "waking | | | | they said I hadn't met it yet. Technically, they |
| up", "fighting for yourself" and so on are good | | | | were right. My employer switched health care |
| places to start. | | | | providers in March of this year, so technically I |
| And they also require us to practice certain things | | | | hadn't met my deductible with the new insurance |
| like standing up to people and things like not giving | | | | company. However, like I said, I was certain we |
| up. | | | | had been to the emergency room a few other |
| These things are not easy to do, and I think a lot | | | | times with my son in 2009. |
| of us out there decide to take the "easy way | | | | After some more digging and some more calls to |
| out" sometimes. We just let ourselves get run | | | | the emergency room billing department and the |
| over by people (or companies) rather than fighting | | | | insurance company, it turns out that in cases like |
| for what is rightfully ours. | | | | these, many times, insurance companies will have |
| I have been speaking in concepts and | | | | what is called a "carryover" policy to where in this |
| hypotheticals so far, here is the meat of my | | | | instance, the fact that I fulfilled my deductible with |
| story. When you see something happening in your | | | | the old insurance company will still count with the |
| life where you know someone is trying to take | | | | new one. |
| your money unfairly, or you come up against | | | | No one could tell me for sure that this would be |
| some company policy that you know is unfair-you | | | | the case in my situation, but this is where things |
| need to fight back! You need to step up and do | | | | stand right now. I keep detailed records of all my |
| what it takes to get your money back! Or, if it | | | | son's doctors' visits (for tax reasons and plus, as |
| hasn't been taken yet, to keep it from happening. | | | | you can see, you never know when you're going |
| I will try to be brief and give you just the main | | | | to need them). I got together the records of my |
| facts. Last month, we had to take our son to the | | | | son's two previous visits to the emergency room |
| emergency room. It turned out to be bronchitis, | | | | in 2009, complete with where I fulfilled my |
| we just ended up taking him there because by | | | | deductible, and a copy of this most recent bill. |
| the time we realized he needed to see a doctor, | | | | I have emailed the person that deals with benefits |
| our primary care physician was closed and he | | | | at my employer's home office and I'll be faxing all |
| needed some medical attention. He is fine now, | | | | this stuff over to her today. I am fairly certain |
| but we did have to go to the emergency room. | | | | that I will get $500 knocked off of this bill, and will |
| This happened in November and I just got the bill | | | | only be paying around $100. Of course, a lot of |
| in the mail. The total for all the services | | | | things had to take place for this to happen. |
| performed was right around $1200. Which sounds | | | | I had to be smart enough to realize that this bill |
| about right. However, after insurance paid their | | | | sounded wrong (this is called "paying attention"). |
| part, the hospital (or actually, the insurance | | | | I had to make the effort to find out what was |
| company) was claiming that I still owed almost | | | | going on (calls to the insurance company calls to |
| $600 of this. Since my son has been born, we | | | | the emergency room billing department, and |
| have been to the emergency room a time or | | | | many, many minutes spent on hold). |
| two and normally after all is said and done, I | | | | I had to already have the documentation handy |
| usually owe about 10-15% of the bill. In this case, | | | | (my son's medical records, just a step away in |
| I would have thought it would have been about | | | | my filing cabinet). |
| $150. This was calculated just by going by what I | | | | Now, I just have to follow up and follow through. |
| had paid in the past. | | | | My insurance carrier should have this "carryover" |
| I knew there was something funny about this bill; | | | | policy. If they don't, you can bet that I will still |
| I just didn't know what it was. At first, I thought I | | | | fight for myself. There is a chance I won't win, |
| would just pay it (you see, I almost got lazy | | | | but I will not go down without a fight. If we were |
| myself!) but then again I knew that there was | | | | talking about $20, I may not go to this trouble. |
| something wrong and I was going to get to the | | | | Considering that $500 is close a full week's work |
| bottom of it and fight like hell before paying out | | | | for me, I'd be a fool not to invest the time and |
| $500 more than I thought I should owe. | | | | effort into trying to get this fixed. |
| After calls to the hospital and the insurance | | | | |