$3100 bill for "completely covered" procedure.
December 19, 2013 3:12 PM Subscribe
My doctor sent me for a colonoscopy due to family history. The clinic gave me some paperwork saying it would be completely covered unless they found something, and then it would be $250. They didn't find anything. I lost the paperwork. Now they're sending me bills for $3100.
posted by johnofjack to Health & Fitness (24 answers total) 2 users marked this as a favorite
I had the procedure done on September 26. I've gotten a number of bills since then.
I've called the insurance company a number of times. They've told me on two different occasions that the doctor's office coded the claim wrong and that it should have been covered--and will be covered, if they resubmit the claim with the correct code. The doctor's office coded the procedure as "diagnostic"; I'm 38, diagnostic colonoscopies aren't covered till 50--but my father died of colon cancer which had metastasized to the point it was inoperable by the time they found it when he was 43, so according to the insurance company it should have been coded as family history/high risk.
After each of my calls to the insurance company, they called the doctor's office to advise them to resubmit the claim with the correct code. And then each time I got a phone call within two days, from the clinic, attempting to get me to pay this $3100 bill I had no reason to expect. The clinic says they can't change the claim; the doctor has to do it.
I've also called the doctor's office directly, doubting it would do any good when a call from the insurance company didn't, and indeed it didn't. Meanwhile I keep getting bills and annoying phone calls.
Our workplace has an insurance advocate. Today the insurance advocate told me the same thing the insurance company did: the doctor's office needs to solve the problem. The doctor's office is not solving the problem.
At this point it feels like they've done a bait and switch, or maybe they're just leaning on me to give them a $3,100 interest-free loan until they can sort out whatever problem they're having in the office.
What is the next step here? Please assume I have, on a scale of 1 to 3,100, zero intention of paying this bill and every intention of getting them to correct their mistake.