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Friday, August 1, 2008

Who's More Incompetent?

So, for the past few weeks, I have been receiving duplicate explanation of benefits in the mail from my insurance for a doctors visit back in November of 2007... you know 9 months ago... when I had the flu the 1st time...

I kept remarking to Jim, these people (referring to the insurance company) need to get their act together. I don't know why they keep sending this! (And just to clarify, it was definitely an EOB and not a bill).

Then, in the mail today, I get a BILL from the doctor's office for 2 visits that were not paid. (Side Note: pregnancy hormones combined with incompetent people make for angry conversation). So, I immediately dial the 800# for the billing company to sort this obvious mistake out. Especially knowing that the doctors office I go to (and the insurance plan that I have) requires payment at the time of the visit... you cannot leave the office without paying, and my insurance plan requires me to meet my deductible before they pay anything... (in other words, I owed the full amount at the time of the visit)

Well, back to the phone call. It was 4:45pm when I placed this call (for the most part I would say I was calm)... and then the recording:
You have reached XYZ Billing Company our office hours are Monday through Thursday 8:ooam to 4:00pm (to which I muttered: "Dangit, it's after 4:00, oh, wait, it's Friday, they must have extended hours on Friday", you know like the banks) and then the rest of the recording: Friday's 8:00am to 12:00pm... WHAT???? 12:00pm???? ARE YOU KIDDING ME???? WHAT OFFICE DO YOU KNOW CLOSES AT 12:00pm ON FRIDAY'S???? DO YOU NOT REALIZE I AM SEETHING RIGHT NOW, FULL OF PREGNANT RAGE????

I quickly hung up the phone and dialed the doctors office... Certainly, they can straighten this thing out...

Me: Yes, I received a bill in the mail today for an office visit from back in November of 2007

Receptionist: Ma'am you'll need to contact our billing company. Their name and number is <...>

Me: Yeah, I called them already... they close at noon on Fridays. You don't understand, this is from a visit 9 months ago. That I paid for.

Receptionist: One moment ma'am, let me get the office manager for you.

Office Manager (OM): May I help you?

Me: (explain the situation again, trying not to cry as I feel it will show weakness in my attack on incompetency)

OM: Well you will need to speak with our billing company.


OM: I can provide you with that print out- just come by the office...

So, I drop everything (not that there was a lot going on) and drive up to the doctors office, only to find that they do not have a record of me making any payment on the 2 visits in which I am being billed for... WELL, DUH KELLY, IF THEY HAD RECORD, THEY WOULDN'T BE BILLING YOU...


OM: Well how did you pay?

Me: I would assume with my debit card!

OM: Well, all you have to do is show that you made payments and we can take care of it for you.

Seething, even more, I turn around and walk out. I pull up my bank statements for that month... WHAT DO YOU KNOW??? Payment on 11/5/07 and 11/28/07 for this doctors office.

5:45pm (15 minutes before the office closes)
Me on the phone to the OM: I have two bank statements here showing that I paid to your company "X" amount of dollars on "X and Y" day.

OM: Just bring it by on Monday and we will research it. It is probably just an oversight on the part of the billing company


I ask you, dear readers, who in this scenario is responsible? Not the insurance company, as I first proclaimed, for sending me multiple EOB's, while annoying as it was...

Was it the billing company? Maybe if they stayed open a little longer on Friday's they could catch blatant mistakes like this....

Or, was it the doctor's office? Did someone drop the ball at the office and not record (not one, but) two payments I made so that the billing company would know NOT to bill me?

Granted, I may be worked-up over "nothing" to some, but when money is tight, and bills come in, it's stressful. Plus, it creates unnecessary work that I have to take care of...



Bekah said...

My darling Kelly. I HATE insurance stuff. All of it. Figuring out what insurance to get, dealing with the doctors, dealing with the insurance company, everything. I totally understand your raging blood. Want me to call and holler too? Two voices must be better than one.

Kelly Spezzano said...

I just wish you lived in Lakeland so I could tell you to boycott this place! LOL

Thanks for the offer to holler. I will have to update everyone how Monday goes. All I have to say is, their research better be as simple as looking at my bank statement and saying "Oh, yes, our research confirms that we are missing your two payments... we'll correct it right away!" And an apology would be much appreciated too!

Dani said...

Insurance companies and doctor's offices are rediculous. The put the burden on you to prove you paid something that happened almost a year ago. When it's their fault that it's not being handled properly.


His Mercy Endureth Forever said...

Hey...I don't want to jinx anything, but I'm still waiting for a bill from the ambulance company from when Brady had to get stitches 3 years ago! They sent me a bill for it but didn't send it through insurance first so I called them and I'm still waiting to hear back from them!

Anonymous said...

Hey Kelly, I'm just so impressed with your graphics on your blog. How do you find all these neat graphics. They really inhance your story line. Welcome to the world of orginized confusion. It's intentional you know. They even have school to teach people to add to the confusion. Then they organize the company to be disorganized so that it adds to the confusion. statistically if seven out of ten do not remember that they already paid think of how much money they can add to their bottom line. By the way it was the Dr. office turn to get the blame this time. You know its a computer generated ramdon selection as to whos turn it is to get the blame for a mistake, just in case some one does question the billing. Do you remember that the insurance company that you had, paid a claim to an individual that was at fault, for an accident that you were not even involved in but witnessed,....Without even notifying you. Wow. There would be no way to untangle that one. They are probably only open til 10:00 am. Good for you though, be persistant. Don't let them get away with a dime.


misslissa78 said...

I have great indepth knowledge of this situation having been on COBRA insurance while I was pregnant with Owen and Noah. Let me just say YUCK!
If this happens again immediatly run out and eat a roll of chocolate chip cookie dough. It ALWAYS makes me feel better:-) It also might be why I'm having a hard time losing the rest of my baby wieght:-D

Lori said...

Hey, Kelly, I am so sorry to hear you had to go through all that, but glad that you were so organized you could easily find the information on your statements. I hope you got to the bottom of it today.

Ditto your dad's comment about the graphics.

Take care and God bless,

Owl of the Desert said...

Whew, what a mess! I would be screaming, too! Hope it all gets worked out today.