Sunday, March 22, 2009

Biopsy payment

When my tumor was biopsied in December, my insurance paid for the procedure at my local hospital, but not for the interpretation of slides done at the University of Iowa (which for some reason came as two separate bills). I called my insurance company, and was told the University of Iowa was out of network. That was discouraging.

I asked my oncologist's office about this, and they said, no, that wasn't right, they would resubmit the bills. A few days later, I got a slip from my insurance company that they were going to pay one of the bills. That was a big step in the right direction.

A few weeks went by with no word on the other bill, so Friday I called my insurance company. The agent was very confident that U of I was out of network, and that bill was not going to be paid. I pointed out the other bill (part of the same biopsy interpretation) that they had paid. No, she said, U of I was out of network, and they hadn't paid that. (!)

We went back and forth a few times, she insisting it hadn't been paid, me insisting it had. On March 3rd it was paid, I told her, find an action on that claim on March 3rd. February 18th, March 2nd... then she found March 3rd. There was silence for a minute. I was really afraid she was going to find something to un-pay it.

Then a light bulb must have gone off. "Did you go to the University of Iowa?" No, my biopsy was done at my local hospital. Only the slides were sent to U of I. Well, that was entirely different. Of course they would pay. She apologized for the trouble they had caused me.

Good news, but how bizarre. I would have thought the thousands of dollars in hospital bills would have clued them off that I was in my local hospital that day. Or that the procedures being billed from U of I would have obviously been done on slides, not an actual person. Considering all the money that passes through their system, health insurance does not seem as with-it as one would hope.

No comments: