Insurance company and pain clinic say ignore the bills

by fireyone » Mon Dec 29, 2008 12:11 am

I am still getting bills from the hospitol where my pain clinic is located. A while back I had called my highmark insurance over getting double co-pays and after the agent looked into it she called back and said I did not have to pay the second co-pay (on facility fees). The first co-payment would be may payment in full.
Two weeks I called to get a new appointment at the clinic and they told me the same thing. A little later I started getting demands for payments in the mail and called my insurance company back..they said it was taken care of but I am still getting bills. When I call the hospitol they say the will not erase the charges..they can't. They say unless they are informed from my insurance company (which they have called and informed them twice) the bills will remain and if not paid turned into collections. I have good credit and do not want this. I could just pay all the co-pays but they are quite a bit and if my insurance company and the pain clinic who actually sees me says I do not owe what can I do? It seems like lines of communication are getting crossed somewhere.

Total Comments: 9

Posted: Mon Dec 29, 2008 12:57 am Post Subject:

Welcome to the world of medical providers and insurance companies not communicating!

My recommendation is that you obtain a mangers name at the hospitals billing department and then get a hold of a manager at the insurance company. Ask the insurance company manager to call the hospital manager in order to get the situation corrected.

I think this is the case of the hospital not knowing (and not caring) how your plan works (but they certainly like the payments your insurance company is making) and a case of the insurance company not making sure the hospital takes care of the incorrect billing.

Posted: Mon Dec 29, 2008 09:52 am Post Subject:

My recommendation is that you obtain a mangers name at the hospitals billing department and then get a hold of a manager at the insurance company.


I don't think obtaining the managers' names would be a problem..but it could be real problem if you try reaching out to them. Either they are out-of-station or they have busy schedules. It is your run-around time my dear!

This is the reason..I'd always make sure that I get treated under a hospital which is enlisted with my carrier. Then I'd just need to show them my health-card provided by my carrier while I get admitted in the health clinic and the rest would be up to them to settle the cost.

Posted: Mon Dec 29, 2008 01:46 pm Post Subject:

I actually did go with an in-network provider. The problem is the hopsitol has a special pain clinic on their property that I go to. The pain clinic charges me my deductuble and I pay each time I go. I had never relized that the hospitol was charging a facility fee also until my car insurance med-pay ran out. Then I started recieving past bills from the hospitol with a co-pay for "facility fees". So each time I was going they were charging me a seperate co-pay for each. I called Highmark and the worker assigned to my case had to do a lot of calling to even get them to return just one call. She assured me that it was taken care of and I would have no future or past charges. She also said she spoke with the hospitol on this and I had no worries. When I called back a few weeks ago she recalled them and got the same thing.
Now when I call billing to make sure it is all cleared up they inform me differently. I also called the pain clinic and they say it is all strasightened up so why won't the billing dept. at the hospitol comply? I am going to try Highmark again and let them know this is getting no where. Maybe even do as T-scope suggested and get a manager on the phone. Thanks.

Posted: Mon Dec 29, 2008 03:27 pm Post Subject:

This is without question the stupidest part of ins. and health providers business. cannot tell you how many times, i've had to handle this stuff for my grandparents and parents....

Do as Todd recommended, I'd also have the carrier send ME the letter, and I would then hand deliver it (copy) to the manager of the billing dept, and tell them I'm waiting for a bill showing paid in full....and that is what I would do...in fact knowing me I'd end laying on the ground if I had to wait too long....this is so stupid...one key stroke and they could handle this..i don't care what they told you....it can be done and is done multiple times a day...keep climbing the hospital ladder till you get someone that CAN do it...geeeeeeze this irritates me...i'm sure you are nuts over it...no way in the world would 'i' pay those bills...ever...

Posted: Mon Dec 29, 2008 10:22 pm Post Subject: insurance

You would think there would be someone SPECIFIC, in the Billing Dept, that would handle such things. It IS easier to just deal with ONE person ( if possible) about the issue. Trying to deal with 50 'professionals' and explaining the issue 50 times can get a bit frustrating. I'm surprised you haven't pulled your hair out, yet!! :roll:

Posted: Tue Dec 30, 2008 12:07 am Post Subject:

The hospitol billing dept. itself will not put me through to anyone. They only tell me that it can not be taken away (the co-payments). I am going to call Highmark tomorrow and see where the lines of communication are crossing. Something tells me MAYBE the Highmark worker is talking to someone in the pain clinic office and not the billing. I am past frustrated. I was going to call today but it has been ONE BAD DAY. Went for a new patient visit at a docs office closer to home. They either do not listen to people or like to put them in agony. The doc wanted me to open my right hand completely and I explained I could not due to the RSD. She reached out and tried to pull my fingers straight and sent me reeling in pain. On top of that they did some strength test and seemed annoyed that I could not queeze much with my right hand (injured one). She kept yelling "harder, harder" and I kept saying "I can't". In the end I told her IO wasn't sure if this was the office for me and left in tears. I really did not want to cry but DAMN that hurt.

Posted: Tue Dec 30, 2008 07:22 am Post Subject:

Either they are out-of-station or they have busy schedules. It is your run-around time my dear!



I've experienced that it always becomes the policy holder's headache to straight the things out. You insurer and the service providers aren't communicating amongst themselves, and you have to take the pain to get them in touch and sort the matter out. Isn't it enough that you have made the premium payments regularly? And now you are fearing that a wrong entry is about to enter in your credit report with no fault of yours. Its really frustrating :mad:

Posted: Tue Dec 30, 2008 07:27 am Post Subject:

A small voice in my brain is tellign me that its time to file a complaint with the State Insurance Department against your provider for not being co-operative. Call them up and let them know your intenstion. Hope it'd ring the bell for them :wicked: Good Luck!!

Posted: Tue Dec 30, 2008 01:39 pm Post Subject:

It doesn't seem like my insurance company is the problem. It is the billing at the hospitol. As soon as I call the lady that handles it always gives me the same old lines. It is straightened out at the pain clinic and they have spoken to billing and the insurance company is saying my deductibles are all satisfied. I would not even bother if it were not for my credit record. Going to call today...I will update later.

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