This is the most common advice. Never listen to your doctor’s office, or a lab you are visiting or a surgery center if they say “oh, we take your insurance, you are covered.”
What is the most effective way to get the right answers from your insurance company? Is it recommended that you call their customer service line, navigate that process, talk to a human being and then write everything down and get their name and date and open some sort of a customer service number?
Is it adequate to try the insurance web site (since many are getting pretty robust) or is that not enough and you should talk to a human being?
I have a diagnostic procedure coming up that I had scheduled once before Covid hit. I had called my insurance company to confirm the procedure was covered and the facility was in network, and confirmed that there would not be a fee. I had the codes provided by the doctor. I asked very clear questions, I wrote extremely detailed notes. I had a case number and a person’s name.
When it was the Friday before the appointment (Monday) I received a voice mail from the surgery center stating I needed to be prepared to pay a large chunk of money upon arrival so to please plan ahead with payment. It was too late to call the place back. I had to call them Monday morning and try to sort it out. They said no, my insurance did not cover it, sorry, you need to bring the money. I called my insurance company and they said that I did need to pay it. I gave them my codes again and the case number, person I talked to, and details of our conversation. It took a half hour. A lot of being on hold. Had to go up to a supervisor. Went through the codes again. Then ultimately they conceded that the surgery center was wrong, it what I was told originally was correct. By then I had already canceled the appointment. I rescheduled it. Then covid happened so it got canceled anyway. It’s time for me to call and get it planned again, so I am going through the process once more but with new insurance.
The frustrating part is that the recording when you are on hold states “explanation of benefits it not a guarantee of coverage”. That pretty much covers their ass and they can change their mind or rules. I feel like most people would just get to their procedure and at that point hand over their credit card because what else can they do? Or if they did what I did, they’d have to spend a long time navigating a process and being on hold and eventually give up, and I just didn’t give up. It was over an amount of money that was less than my hourly rate for work if I had calculated all the time I wasted on calls and following up. Is this their strategy?
What’s the fastest and most solid way to get the right info?
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submitted by /u/kaysharona
[link] [comments]
This is the most common advice. Never listen to your doctor’s office, or a lab you are visiting or a surgery center if they say “oh, we take your insurance, you are covered.” What is the most effective way to get the right answers from your insurance company? Is it recommended that you call their customer service line, navigate that process, talk to a human being and then write everything down and get their name and date and open some sort of a customer service number? Is it adequate to try the insurance web site (since many are getting pretty robust) or is that not enough and you should talk to a human being? I have a diagnostic procedure coming up that I had scheduled once before Covid hit. I had called my insurance company to confirm the procedure was covered and the facility was in network, and confirmed that there would not be a fee. I had the codes provided by the doctor. I asked very clear questions, I wrote extremely detailed notes. I had a case number and a person’s name. When it was the Friday before the appointment (Monday) I received a voice mail from the surgery center stating I needed to be prepared to pay a large chunk of money upon arrival so to please plan ahead with payment. It was too late to call the place back. I had to call them Monday morning and try to sort it out. They said no, my insurance did not cover it, sorry, you need to bring the money. I called my insurance company and they said that I did need to pay it. I gave them my codes again and the case number, person I talked to, and details of our conversation. It took a half hour. A lot of being on hold. Had to go up to a supervisor. Went through the codes again. Then ultimately they conceded that the surgery center was wrong, it what I was told originally was correct. By then I had already canceled the appointment. I rescheduled it. Then covid happened so it got canceled anyway. It’s time for me to call and get it planned again, so I am going through the process once more but with new insurance. The frustrating part is that the recording when you are on hold states “explanation of benefits it not a guarantee of coverage”. That pretty much covers their ass and they can change their mind or rules. I feel like most people would just get to their procedure and at that point hand over their credit card because what else can they do? Or if they did what I did, they’d have to spend a long time navigating a process and being on hold and eventually give up, and I just didn’t give up. It was over an amount of money that was less than my hourly rate for work if I had calculated all the time I wasted on calls and following up. Is this their strategy? What’s the fastest and most solid way to get the right info? ,
submitted by /u/kaysharona [link] [comments]Read Morer/HealthInsurance