Friday, January 29, 2010

A shock to the system

Last night we had dinner with a new business partner for Torsten's company. We went out to one of our favorite brewpubs and had a lovely meal. It was a great meeting and the guy we met with was nice, helpful, and very enthusiastic.

It was also the first time I'd eaten at a restaurant in a month. And you know what? I hadn't missed it. And you know what else? It was good, but not any better than the food I've been cooking at home. It didn't tap into any sort of deep craving for more restaurant food. In fact, I think I'm pretty much set for the next month. Or until the next business meeting.

Also, the partner paid for dinner. So that was awesome, since we suddenly have zero extra cash.

Speaking of cooking, I made a new dish the other day. I'll post the recipe on my recipe blog (which I have reactivated, FYI), but let me just say that I had some cream about to go bad in my fridge because we bought too much at the holidays, so for the first time in my life, I cooked with cream. And lo, it was delicious. AND I ate so little of it that I still lost weight the next day.

The lap-band, it is awesome.

In other news, yesterday I got a call from the hospital that did my genetic testing, telling me that my insurance company said that yes, genetic testing is a covered benefit, so I could go ahead and have my testing done at any time. So I told the woman that I had already had my genetic testing done, and had even received the results (not a carrier, as expected). So THEN she looked me up in her billing system and said the following:

"The cost of this service was $4,592.60. Of that, your insurance company paid $65. You should be receiving a bill shortly for the difference."

Can you say INSTANT HEART ATTACK? I swear the hospital must do this on purpose to try to drum up more business for themselves. I almost had a stroke on the spot.

A bit of background: the testing doesn't REALLY cost that much. Insurance pays specially negotiated lower rates, so their cost would probably actually be more in the range of $2000. If you know your insurance won't pay, the hospital offers an up-front self-pay rate of $500. However, if you don't pay up front and then your insurance denies the claim, apparently you're responsible for the full amount. Though in this case I think I'd have a leg to stand on since the hospital proceeded with testing without clearing it with me first.

ANYWAY, I should have known that this woman didn't know what she was talking about, since after all she was calling to give me month-old information and had no idea that she was so out of the loop. However, I opted to take her seriously, forced myself not to burst into tears on the spot, and questioned her on why my insurance would pay ANY amount, even just $65, since I have no deductible and in-network hospitals are covered at 100%. It seemed like it should be an all or nothing type of situation, and of course she didn't know, so I called the insurance company.

And, of course, it turned out that the insurance company received the claim but sent it back because it had the wrong code on it, so they don't have it in their system yet. The $65 they paid was for a separate claim filed at around the same time (office visit instead of labs, I think). So, I called the billing department at the hospital and they said oh yeah, they knew, and they had resubmitted the claim the previous day. So, I won't be getting a bill, and insurance will be paying, and everything is fine. Except that I'm pretty sure the shock of being told I owed $4500 for something that should cost no more than $500 shaved a good ten years off my life.

16 comments:

  1. Ugh, your post reminded me that I have a bunch of medical bill issues to work out. Why is it always such a headache?

    Have a great weekend and thanks for your support this week! It feels so good to be blogging again!

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  2. Lol, I would have flipped! I'm not fun when it comes to hospital bills not matching up with insurance.

    We had a period of time where we mostly ate at home and restaurants were a treat - in the last couple months I've slacked on cooking (and eating), so we've (or B's) eaten out more. We'll get back into it, have to!

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  3. ACK! I would thrown up right there on the spot.

    When things like this happen to me and I KNOW the other person is wrong I start to talk r-e-a-l-y slowly with a fake sing-songy voice and ask questions like "since you seem unable to find any answer, who actually can help me?". I'm not sure it does any good to be patronizing but I just can't help it!

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  4. Woah! I think I just had a heart attack for you, even reading all the way to the end and finding out everything is ok. I do not enjoy the stress of dealing with medical bills/insurance.

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  5. That would also have given me a heart attack, holy cow. That's a lot of money! My goal for February is not to eat out for the entire month. Should be a challenge but I think I can make it!

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  6. While I'm a pretty big advocate of health care for all, the one thing that holds me back is medical billing systems. There is such a fracture between services received, services billed for and what's covered that inevitably we all wind up dealing with something that's likely to shave years off our lives. Ugh!

    Glad, though, to hear you held out and sorted everything out. Now you can really enjoy your weekend!

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  7. Yeah, we don't eat out at all really anymore (what with food allergies) and I don't miss it. I actually think it's more of a hassle than bringing my own food. :)

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  8. Insurance companies give me palpitations and not in the good way. UGH!

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  9. OMG! I would have TOTALLY PANICKED and also I would have burst into tears.

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  10. Hate medical bills insurance BS.

    Wish we had your medical insurance though. That sounds so much better than what we have.

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  11. Any encounter with insurance companies and hospitals is horrible. Hate.

    I would have had to mute the phone while I Panic Barfed.

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  12. I had a heart attack for you when I saw your tweet about this! Especially since I know you're trying to be frugal right now.

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  13. i have to admit, i just don't get it when people don't enjoy meals at restaurants. i mean, obviously if the food is bad or the service is poor or there's a negative aspect to it? sure. but i mean, i cook quite well, and my mom is a freaking professional cook & restaurant reviewer, so it's not like restaurant food is leagues better than what i can normally get, but.. oh man. it's still wonderful getting to eat amazing food at a nice restaurant. :-) i guess it's like how some people don't like massages or spa treatments. it's just not worth it to them. or pleasant. and my hedonist brain cannot comprehend :-)

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  14. Don't worry I think it shaved 15 out of mine too!

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