This is a recent personal success story where I saved a large chunk of money that also acts as a tip for other consumers who may run into the same type of issue.
In November 2010 I had a small outpatient procedure done that was required in order to receive another major surgery. Both were covered and approved by my insurance company.
In September 2011 I received a bill for $978 for the outpatient procedure from my Doctor saying that I had an outstanding balance and would be sent to collections. Being the anal bill payer that I am because I don’t go to collections and I don’t have overdue bills, I sorta freaked about it. Granted I have an HSA through my work that had more than enough money to cover this bill, but you never get used to receiving bills for almost a grand. I was considering just paying the bill since I had the money, but decided I better investigate it a little more in case there was a mistake.
I decided to call the doctors office to find out details on this bill, and they said it was kicked back from the insurance company as “not covered procedure“. So I started the aggravating process of calling my insurance company for specific details on why this procedure was not covered. They were actually fairly accommodating and said that despite the major surgery being approved, the outpatient procedure was listed as unnecessary. In order to get the claim filed, I would need to have my doctor send an appeal letter with my medical history explaining why the procedure was necessary.
I went forward with this information, documenting not only the names of everyone I talked to, but the times I called, and the reference numbers they provided to discuss my claim case. I gave this information to my Doctors office and they said they would take care of getting the letter sent out.
I decided to call back this past January to get an update on the status of this balance, only to find out that the outpatient surgery was actually two procedures (one required, one not) performed on the same day (what can I say, I was anesthesized), and that because of how the billing was done, the Doctor decided to go ahead and write-off the balance on my account, meaning I didn’t owe a penny.
I find more and more that medical billing is an artform that is lacking skilled laborers. I’m to the point where I am going to start taking all of my medical benefit statements and doctors statements and compare them regularly along with my payment receipts because there just doesn’t seem to be a clear-cut workflow between the two.
The lesson here is never just pay a bill, especially a medical bill, simply because you received a bill for it unless you know for sure it’s accurate. This can be for any bill, even electricity bills when they do their estimated readings. I know I’ve saved money once or twice by disputing an electric bill.
Pay attention to your finances, but also pay attention to your billed work and procedures. Imagine the amount of money that is overpaid for work simply because people don’t take the time to keep track of what is actually being done?
Also check out a recent Consumerist article on saving on medical bills by questioning charges.
Amount Saved: $978!