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View Full Version : Keep on getting bills for Clinic visits



ldenkers
04-30-2010, 06:47 PM
It seems I am missing something every appointment. I am going back and forth between the insurance and the hospital. I have finally gotten an "advocate" and have about 10k left to dispute. Anyone having trouble with this?

We have a PPO and for boston we did get pre- approval but we moved and my husband's insurance (also PPO) says the John Hopkins doctor is in network. What scared me is the registration papers say that they send two bills and "some" times the insurance pays both, but we are ultimately responsible. I have only had 3 visits since the boys were born and can't imagine having to fight this every time. It's been since Oct 2009 we are still getting bills.

ldenkers
04-30-2010, 06:47 PM
It seems I am missing something every appointment. I am going back and forth between the insurance and the hospital. I have finally gotten an "advocate" and have about 10k left to dispute. Anyone having trouble with this?

We have a PPO and for boston we did get pre- approval but we moved and my husband's insurance (also PPO) says the John Hopkins doctor is in network. What scared me is the registration papers say that they send two bills and "some" times the insurance pays both, but we are ultimately responsible. I have only had 3 visits since the boys were born and can't imagine having to fight this every time. It's been since Oct 2009 we are still getting bills.

ldenkers
04-30-2010, 06:47 PM
It seems I am missing something every appointment. I am going back and forth between the insurance and the hospital. I have finally gotten an "advocate" and have about 10k left to dispute. Anyone having trouble with this?
<br />
<br />We have a PPO and for boston we did get pre- approval but we moved and my husband's insurance (also PPO) says the John Hopkins doctor is in network. What scared me is the registration papers say that they send two bills and "some" times the insurance pays both, but we are ultimately responsible. I have only had 3 visits since the boys were born and can't imagine having to fight this every time. It's been since Oct 2009 we are still getting bills.

Ratatosk
04-30-2010, 07:03 PM
When DS was transferred to a children's hospital for surgery when he was a day old, we got the "out of network" run around. Insurance would tell me one thing, so I'd contact the clinic or hospital and it would turn out that someone else needed to refer us. A couple of times I called insurance and they told us it was taken care of, only to get a statement of benefits which said otherwise and then to find out speaking to a different insurance rep that someone from the clinic needed to fill out a form. First it was the neonatologist on call, then it was someone else... Got a different story every time we called.

NICU total before insurance was $149,000 and insurance kept asking us if we had other insurance to help pay for it. Then there was the $1600 ambulance ride from the hospital to the airport 2-3 miles down the road. None of that was covered.

FINALLY after about 5-6 months the right person filled out the referral information and things were covered. In fact a couple places -- surgeon, anesthesia sent us back checks for over payment.

Contact your insurance company and find out in writing exactly what you need to do to get a referral. In our case our pediatrician (in network) had to submit paperwork to the hospital adminstrator, who handled the referrals.

Ratatosk
04-30-2010, 07:03 PM
When DS was transferred to a children's hospital for surgery when he was a day old, we got the "out of network" run around. Insurance would tell me one thing, so I'd contact the clinic or hospital and it would turn out that someone else needed to refer us. A couple of times I called insurance and they told us it was taken care of, only to get a statement of benefits which said otherwise and then to find out speaking to a different insurance rep that someone from the clinic needed to fill out a form. First it was the neonatologist on call, then it was someone else... Got a different story every time we called.

NICU total before insurance was $149,000 and insurance kept asking us if we had other insurance to help pay for it. Then there was the $1600 ambulance ride from the hospital to the airport 2-3 miles down the road. None of that was covered.

FINALLY after about 5-6 months the right person filled out the referral information and things were covered. In fact a couple places -- surgeon, anesthesia sent us back checks for over payment.

Contact your insurance company and find out in writing exactly what you need to do to get a referral. In our case our pediatrician (in network) had to submit paperwork to the hospital adminstrator, who handled the referrals.

Ratatosk
04-30-2010, 07:03 PM
When DS was transferred to a children's hospital for surgery when he was a day old, we got the "out of network" run around. Insurance would tell me one thing, so I'd contact the clinic or hospital and it would turn out that someone else needed to refer us. A couple of times I called insurance and they told us it was taken care of, only to get a statement of benefits which said otherwise and then to find out speaking to a different insurance rep that someone from the clinic needed to fill out a form. First it was the neonatologist on call, then it was someone else... Got a different story every time we called.
<br />
<br />NICU total before insurance was $149,000 and insurance kept asking us if we had other insurance to help pay for it. Then there was the $1600 ambulance ride from the hospital to the airport 2-3 miles down the road. None of that was covered.
<br />
<br />FINALLY after about 5-6 months the right person filled out the referral information and things were covered. In fact a couple places -- surgeon, anesthesia sent us back checks for over payment.
<br />
<br />Contact your insurance company and find out in writing exactly what you need to do to get a referral. In our case our pediatrician (in network) had to submit paperwork to the hospital adminstrator, who handled the referrals.