Hat Tip to the BBB

Forgive me if I have mentioned this before. With all that I’ve had happen over the last week, I honestly cannot recall if I blogged about this.

My wife and I received a bill from the place that my daughter has physical/occupational therapy. The bill was for $2100. My insurance is the primary and my wife’s insurance is secondary. With both of them, all that we should have to pay is a co-pay.

My wife called to find out why we owed so much. Their response was that the primary insurance was out of network. This didn’t make any sense because there was no issue when my son was doing the same therapy there. So they asked for all the insurance info again and said they would rebill. The bills kept coming and we kept calling them. Each time we gave them all the info and were told they would rebill.

I had enough and called them again, but first I called the insurance company. They assured me that they were NOT out of network. They also told me that only visit they had been billed for was in April. The bill lists visits all the way back to November!

The therapist gave me an email for their customer satisfaction department. So I whipped off an e-mail giving all of the information (again) and explaining that my insurance was primary and not out of network. A few days later I got an email back that said “Sorry, you still owe this money!” They again said that my insurance was out of network and that we had to contact the secondary insurance to get the coordination of benefits right.

I responded with a strongly worded e-mail that said that I didn’t accept their decision. I told them that they are billing wrong. I explained that my insurance said they are not out of network and had never received a claim from them for any visits until April. I told them that it was obvious that they never billed them. I went on to explain that I had seen numerous comments about their poor billing department on the internet (Google reviews and such). I told them that I would be reporting them to the Better Business Bureau.

I filed a claim with the BBB and received a message back that my complaint was accepted. The next steps were that they would contact the therapy place and they would see exactly what I had written to them. Once they did that, they would get with me to see if any action was taken. Well, surprise surprise….they called my wife this morning.

“This should have never gotten this far!” “I am so sorry that you were put in this situation” Blah Blah Blah. My wife said that the woman who called couldn’t have been nicer. Naturally. The woman explained that after the first call the issue should have been brought to her department. She went on to say that she can see where the error was made and would be working to correct the problem.

And now for the kicker. The woman had the guts to say, “Now that we are fixing the problem, we would really appreciate it if you could rescind your complaint with the Better Business Bureau.” Seriously?! My wife said that if this issue had been taken care of after the first one or two calls, we wouldn’t have had to file the complaint. “Well, this could affect the way our business looks to others.” Not our issue. “This will lower our rating or standing with them.” Again, not our issue.

My wife firmly told them that we had no intention of rescinding that complaint. She also stated that if the BBB hadn’t reached out to them on our behalf, they would still be asking for $2100. Basically, she told them that it is a shame that they are more concerned with the way they look rather than making sure their clients are taken care of.

They wound up calling back later in the afternoon to tell us of their “progress” and once again asked us to reconsider taking back our complaint. They were once again told “no.”

I have never filed a complaint before. I didn’t even know if I had done it correctly. I am grateful to them for stepping in for us. It is just a shame that it had to go that far. Hopefully, the next bill we receive from them will be for the co-pays only.

Steaming!

As a customer, all I ask is that you do your job right the first time. If I have to call you more than twice, you will be speaking to “Angry Keith.” Honestly, I feel bad for the “smiling customer care representative” who answers my call.

We’ve used the same physical therapy place for both of our kids. With each one, they have messed up the billing. My insurance is the primary, Sam’s is the secondary. When we call about a bill they either don’t have both insurances or they bill the wrong one. The call always goes the same way – they ask for all the insurance information and say that they will correct the problem.

We received a fourth or fifth bill for my daughter this week. It was for over $2100. They still have not billed it right. So, today I called from work on my break. I explain the situation once again to the lady who answered the phone. She puts me on hold to look at the case. When she returns, she tells me once again that the primary insurance is out of state or out of network, so that is why they billed the secondary and why the secondary only covered part of it.

What this poor soul does not know is that I called my insurance company before I called her. I had them look for any attempts for the therapy place to bill them. The statement is for therapy sessions dating back to November of last year. Surprise, the insurance company says that the only bill that they received was in April of this year. It was covered and all we owed was the co-pay. That is what was supposed to happen with all of the other visits.

I asked the lady at the therapy place if they had billed all of the dates on the statement to my insurance. She says that they did and some claim committee (whatever that is) reviewed this and said that my insurance was out of state/network and that is why they told them to bill the secondary. At this point I kind of lose it.

I tell the woman on the phone that I talked to my insurance company and they never were billed until April. I said that I wanted to speak with someone on this “committee.” She told me, “I’m sorry, sir, but they don’t speak with customers and we can only communicate with them through e-mail.”

“Of course,” I said, “Because they certainly don’t want to speak with a customer like me. They don’t want to admit their mistake, their lie, and have to actually pay for the service that IS COVERED!”

I said a few other choice words, but said, “I need to to e-mail those bigshots on the committee and tell them to rebill those dates of service to the primary insurance, who stated that they have covered the first and only bill they have received from you. You can also tell them that if this isn’t rectified, I will go up the ladder – even if I have to e-mail them!”

If I had a dollar for every time the woman said “I’m sorry,” “I understand your frustration,” or “I will get this taken care of,” I could pay off the bill!

The kicker? After listening to me rant for what seemed like 20 minutes, she then says, “Is there anything else I can help you with, today?” Seriously?!? You didn’t help me with anything today! Even if I had another problem, I wouldn’t ask you to help me with it.

(Deep breath in) (Count slowly to ten)

I hate insurance companies.

Insurance Rant

Look, I understand, we all need insurance. Right? It is supposed to be there for us when we need it. But let’s face it, insurance is one of the biggest money making scams out there. You pay and pay and pay, and when you do need it, you end up jumping through hoop after hoop to get what you need. They always have some clause or reason that you won’t get what you need. It doesn’t seem to matter what the outcome is for YOU, because in the end, the insurance companies keep making bank!

I guess I am going to sound like an old man here, and I am ok with that. There used to be a time where your place of employment gave you decent insurance as part of your benefits. Out of pocket costs were often very minimal unless you had a lengthy hospital stay. People who worked for a hospital or health care were taken care of by their employer. The auto industry also tended to have some of the best benefits. This just isn’t the case anymore.

Years ago, I remember deductibles were reasonable. Now, they are outrageous! How many people actually meet their deductible in a year? Not too many people I know. Now they have higher deductibles for how many people are in your family and so on… They raise them so you will end up paying it (as well as your monthly costs) and they will always come out ahead! Last year I put the amount of my deductible on my FSA card (because when it was all gone, I would know I hit my deductible, right?!). I used it for all out of pocket costs – co-pays, prescriptions, etc. After I had used the entire FSA balance, I got a bill for something and I called the insurance company. I was told that co-pays don’t go toward your deductible. Maybe I am just stupid (or maybe the rules of the insurance companies are so vague purposely), but I questioned just what they considered “out of pocket” costs. To me, if I am paying for it – it is OUT OF MY POCKET! So I got screwed there.

I have found that I am not the only one who pays high costs for medical insurance, only to wind up with a stack of medical bills that I will spend years paying off. And by the time you get close to paying them off, you get hit with another one! A friend of mine who works with some financial company told me that medical debt is one of the reasons so many people in this country are struggling. So many people file for bankruptcy because they will never get their head above water because of medical expenses. Look on Facebook on any given day – there are always “go fund me” pages for people who need help with medical bills. It is SO unfair.

I wish I had a dollar for anytime someone has said to me, “Why do I bother having insurance?!” If I did, I would take those dollars and pay off some of my medical bills! How sad is it that people won’t go to the doctor or to the hospital when they need to because they are afraid of racking up thousands in medical debt?!

So where did this rant come from? Let me tell you. We recently received the bill for Ella’s ear surgery. How much of that was covered by insurance? According to the bill – ZERO. Zilch. NOTHING! Well, you can imagine how well that sat with Sam and I. It was all I could do to not use some choice profanity while I was talking to the insurance representative. The bill was close to $9000! The entire surgery took 6 minutes! (That works out to $1500 a minute! Nice gig, huh?!)

When the ENT called to talk about the bill prior to surgery, they told us our cost (after insurance) was less than $800. As a matter of fact, they even offered to take 5% off the bill if we paid it all off prior to the surgery even happening. Gee, thanks! Anyway, when that bill showed up, Sam and I about lost it. All we had to see was “claim denied” in big red letters at the bottom and our anger (and stress levels) were through the roof!

So I called and got some clown with a smile in his voice on the line. I held back all my anger and explained why I was calling. He stated that he needed to make sure that there was no other insurance that might be considered “primary” insurance that would cover this. I told him no, we only had this insurance. He immediately stated that they would rebill it and take care of it and we should see an adjustment within 7-10 days.

So what is that all about?! I can barely afford the insurance YOU provide. I guess the answer is to pay for more than one insurance policy in order to make your bills. But in the end, if I am paying for more than one insurance, is it really saving me any money? These insurance companies have you by the shirt collar and you are their pawn. You need insurance. Yet, you will still go into debt with it. I just don’t get it.

Don’t even get my started on car insurance…. because that is just as bad or worse!

Ok. I’m raising my blood pressure, so I will stop. I’ll be ok …. until the new bill arrives!