Several weeks ago, my doctor told me to go to the emergency room. I did. Now the bills are arriving. I thought I had good health insurance. I do. But, my stated coverage and the bills don’t agree.
In-network. Deductibles. Out of pocket expenses. 80% here. 90% here. Medically necessary. Negotiated rates. Denied because of an incorrect number.
I try to be responsible with my and the insurance company’s money, but I don’t always understand. I’m not great at surprises. I want to know the rules. I want to play by the rules. I don’t want the rules to change.
Yesterday, I called the insurance company (Aetna). I spoke with a wonderful woman. It’s not often enough that I get the nice, helpful, intelligent, English-speaking customer service rep. She looked up each bill and explained what I really owed and why. The hospital billed incorrectly so Aetna has ask them to resubmit – don’t pay anything yet. The pathology lab billed incorrectly asking for payment of the part that Aetna and the doctor agreed to write off – pay a much smaller amount than what the bill asks for. One doctor asks for a large amount – pay it because that includes your $250 deductible and now you’ve met that deductible you won’t pay it again this year.
I appreciated the help for what is way too confusing for me. How can an average person understand and get this right? And there are more questions …
Do I pay the bills now? Do I wait for corrected bills? Do I hope that everything gets worked out through this bureaucratic system on its own? Do I pay what the insurance company says is correct? Do I pay what the doctor says is correct? Do I pull my hair out and deal with increased pain because the stress of figuring this all out is overwhelming?
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