(To preface, I don’t know anything about insurance and the information detailed here is my understanding of the situation but is as accurate as I can remember. I’m very anti confrontational so I really screwed the pooch not pushing more with the reps I spoke to)
Ok the title is definitely over dramatic but my god, do I DESPISE dealing with them. I have banner/Aetna insurance in phx AZ. I chose this insurance with my employer, and coverage started January 2020. First time signing up for my own health insurance after being kicked off my dads. I had selected a PCP when I signed up online, but when I went in for a visit, the doctor advised that she is just a gyno, not a pcp and she wouldn’t refill my antidepressants.
I then started to call Banner’s list of in-network doctors and a majority of the numbers were either dead lines or they weren’t taking new patients.
On the banner website, I was able to book an appointment at an urgent care (dumb move on my end) to get my prescription refilled while I tried to find a pcp. They gave me a 2 week refill to hold me over, I paid the $50 copay, and continued my search. (Feeling stupid af for paying $50+prescription fee for 2 weeks of antidepressants but whatever) this will come into play in a bit.
I finally was able to book an appointment at a BANNER clinic (not urgent care) with a BANNER doctor, that was listed on the BANNER website.
Now, here’s my other rookie mistake, I didn’t know I had to call to change my listed PCP (which again was an ob-gyn that was listed as an option for pcp when I first signed up).
Anyway, I went to my appointment to establish a PCP and refill my scripts, no additional services were provided.
Two months later, I got a bill for $221. I called them up to see what that was about, and I was told it was the final bill for my urgent care visit. I spent basically all of 2020 calling Banner, calling Aetna, calling and calling and emailing and calling again which got me no where because I thought I was disputing the urgent care bill while (I’m assuming) they saw it was something else but NO ONE CLARIFIED THAT WITH ME. Every rep I spoke to after the first one looked at the claim and agreed that it was weird I’m being billed for that, and each of them told me they would escalate for further review. I didn’t get any names and didn’t take notes of the calls…so I learned my lesson there.
ANYWAY this year, in yet another phone call to Banner, I was finally made aware that this was for my PCP visit at the banner clinic, and not the urgent care visit. They said I was being billed $220 since that doctor wasn’t listed as my PCP at that time, therefore was “out of network”. They said they were going to re-bill it as a new patient visit so that I wouldn’t need a referral. I was relieved thinking it was finally resolved.
Then I got notice from Banner that they sent $574 to collections. $574? Called again… was told they DID bill it as a new patient, that claim was ALSO denied, and that “new patient visit” was $353 on its own. So they sent both the new patient visit bill and the out of network bill to collections. To confirm, these were both for the same visit. I’ve called another handful of times to see why I’m being charged twice for the same visit and NO ONE CAN ANSWER, it just gets “escalated” and I never hear back. Most recently, the rep I spoke to gave me details on how to submit a formal appeal and what exactly to include in that appeal. That appeal was denied and I got a generic response of “they weren’t your primary care physician so you owe that” but they didn’t address why I owe two bills. I’ve contacted the collections account to dispute it, and they said banner denied that dispute as well. I also filed a complaint with the BBB as a last ditch effort-didn’t help lol.
Like, what the hell… I’m just a clinically depressed dumbass trying so hard not to go into medical debt like so many others I know are. I know $574 isn’t the end of the world but on principle, I don’t want to give them that money because they can’t tell me why I owe two bills for the same appointment. I knew America’s health insurance is a joke, but I also know not having insurance isn’t an option.
I guess I’m here to ask, is there any other route I can take to have them remove the bill? Am I stuck paying the $574 collection? How bad would it be if I just didn’t pay it? I’m terrified to use my insurance now.
submitted by /u/idfk1359
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(To preface, I don’t know anything about insurance and the information detailed here is my understanding of the situation but is as accurate as I can remember. I’m very anti confrontational so I really screwed the pooch not pushing more with the reps I spoke to) Ok the title is definitely over dramatic but my god, do I DESPISE dealing with them. I have banner/Aetna insurance in phx AZ. I chose this insurance with my employer, and coverage started January 2020. First time signing up for my own health insurance after being kicked off my dads. I had selected a PCP when I signed up online, but when I went in for a visit, the doctor advised that she is just a gyno, not a pcp and she wouldn’t refill my antidepressants. I then started to call Banner’s list of in-network doctors and a majority of the numbers were either dead lines or they weren’t taking new patients. On the banner website, I was able to book an appointment at an urgent care (dumb move on my end) to get my prescription refilled while I tried to find a pcp. They gave me a 2 week refill to hold me over, I paid the $50 copay, and continued my search. (Feeling stupid af for paying $50+prescription fee for 2 weeks of antidepressants but whatever) this will come into play in a bit. I finally was able to book an appointment at a BANNER clinic (not urgent care) with a BANNER doctor, that was listed on the BANNER website. Now, here’s my other rookie mistake, I didn’t know I had to call to change my listed PCP (which again was an ob-gyn that was listed as an option for pcp when I first signed up). Anyway, I went to my appointment to establish a PCP and refill my scripts, no additional services were provided. Two months later, I got a bill for $221. I called them up to see what that was about, and I was told it was the final bill for my urgent care visit. I spent basically all of 2020 calling Banner, calling Aetna, calling and calling and emailing and calling again which got me no where because I thought I was disputing the urgent care bill while (I’m assuming) they saw it was something else but NO ONE CLARIFIED THAT WITH ME. Every rep I spoke to after the first one looked at the claim and agreed that it was weird I’m being billed for that, and each of them told me they would escalate for further review. I didn’t get any names and didn’t take notes of the calls…so I learned my lesson there. ANYWAY this year, in yet another phone call to Banner, I was finally made aware that this was for my PCP visit at the banner clinic, and not the urgent care visit. They said I was being billed $220 since that doctor wasn’t listed as my PCP at that time, therefore was “out of network”. They said they were going to re-bill it as a new patient visit so that I wouldn’t need a referral. I was relieved thinking it was finally resolved. Then I got notice from Banner that they sent $574 to collections. $574? Called again… was told they DID bill it as a new patient, that claim was ALSO denied, and that “new patient visit” was $353 on its own. So they sent both the new patient visit bill and the out of network bill to collections. To confirm, these were both for the same visit. I’ve called another handful of times to see why I’m being charged twice for the same visit and NO ONE CAN ANSWER, it just gets “escalated” and I never hear back. Most recently, the rep I spoke to gave me details on how to submit a formal appeal and what exactly to include in that appeal. That appeal was denied and I got a generic response of “they weren’t your primary care physician so you owe that” but they didn’t address why I owe two bills. I’ve contacted the collections account to dispute it, and they said banner denied that dispute as well. I also filed a complaint with the BBB as a last ditch effort-didn’t help lol. Like, what the hell… I’m just a clinically depressed dumbass trying so hard not to go into medical debt like so many others I know are. I know $574 isn’t the end of the world but on principle, I don’t want to give them that money because they can’t tell me why I owe two bills for the same appointment. I knew America’s health insurance is a joke, but I also know not having insurance isn’t an option. I guess I’m here to ask, is there any other route I can take to have them remove the bill? Am I stuck paying the $574 collection? How bad would it be if I just didn’t pay it? I’m terrified to use my insurance now.
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