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Either my clinic or the insurance company fudged.
I have already made the call and had the issue corrected (AFAIK, I'll know for certain when the new bill arrives), but I really want to know whose fault it really was.
I got my bill from the clinic from my last shot in September, which was covered at 100%, as usual. But the thing was, I noticed I still had a remaining balance from June where it showed that my shot was not being covered at ALL. If anyone isn't aware, the birth control shot is well over $100.
So I called the clinic and asked what was up. They blamed the insurance company, saying that their records indicated that the insurance company denied my claim and were going to put it towards my deductible (even though I already met that deductible two years ago).
The receptionist at the clinic suggested that I call the insurance company to see why they didn't cover it. Now, I should probably mention that this year, my employer switched insurance companies, but I can still call the old one and they still have my old stuff.
I called the insurance company and they blamed my doctor. They said that when they received a claim, the doctor that you see (even though I don't see an actual doctor for my shot, just a nurse) puts down if they are an in-network partner for that insurance company or not, and according to their records, my doctor had listed herself as a NON network provider, even though my shot BEFORE that, she said she was, and my last shot in September, she said she was.
So the rep said that since that didn't make any sense, they were going to fix that, because it should be covered at 100% and that my doctor IS an in-network provider.
But if anyone here can tell me, whose fault was it really?
Anyone think it's time for me to switch clinics or doctors? I already switched insurance companies so I have yet to see if the new one fudges or not.
I have already made the call and had the issue corrected (AFAIK, I'll know for certain when the new bill arrives), but I really want to know whose fault it really was.
I got my bill from the clinic from my last shot in September, which was covered at 100%, as usual. But the thing was, I noticed I still had a remaining balance from June where it showed that my shot was not being covered at ALL. If anyone isn't aware, the birth control shot is well over $100.
So I called the clinic and asked what was up. They blamed the insurance company, saying that their records indicated that the insurance company denied my claim and were going to put it towards my deductible (even though I already met that deductible two years ago).
The receptionist at the clinic suggested that I call the insurance company to see why they didn't cover it. Now, I should probably mention that this year, my employer switched insurance companies, but I can still call the old one and they still have my old stuff.
I called the insurance company and they blamed my doctor. They said that when they received a claim, the doctor that you see (even though I don't see an actual doctor for my shot, just a nurse) puts down if they are an in-network partner for that insurance company or not, and according to their records, my doctor had listed herself as a NON network provider, even though my shot BEFORE that, she said she was, and my last shot in September, she said she was.
So the rep said that since that didn't make any sense, they were going to fix that, because it should be covered at 100% and that my doctor IS an in-network provider.
But if anyone here can tell me, whose fault was it really?
Anyone think it's time for me to switch clinics or doctors? I already switched insurance companies so I have yet to see if the new one fudges or not.
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