Wednesday, October 8, 2008

i feel 300 pounds lighter

ok, maybe not 300 pounds lighter. but definitely lighter.

yesterday i started to write a post about how frustrated i was with the people at the doctor's office. the doctor that is doing vrock's surgery next week. i was so angry i was on the verge of tears all afternoon.

our insurance kicked in on 9/1 and knowing that, we didn't go to the doctor until after that. we have a $3000 deductible and a health reimbursement account of $750 from my work. basically that means the hra pays the first $750 and we pay the remainder. after that everything is covered at 80%. because our insurance didn't start until 9/1 though, both amounts were prorated for the rest of the year. (at $1000 and $250) vrock had to have a ct before we could officially determine he needed surgery. then he had to go see the surgeon so he could look at the scan. neither item has been billed to our insurance yet.

that being said, when the surgeon's office called the insurance they were told that we have a $1000 deductible and a $250 hra account. so what does the surgeon's office do? they called vrock yesterday and basically said "you need to bring in your deductible amount before surgery so that you can have your surgery." excuse the fuck out of me! so he called me and told me and i went ballistic. i called the office and our exchange went a little something like this:

me: this is vrock's wife. i understand that you called my husband & told him that we had to bring $1000 in to your office before he could have surgery.

snotty bitch at surgeon's: that's not exactly what i said. i called your insurance company and they stated that your deductible has not been met. with a high deductible, the doctor requires that it be met prior to surgery.

me: wtf?!?!? look. yes, we have a deductible of $1000. we also have a hra which is $250 so that our portion is only $750. on top of that, vrock has had a ct scan on 9/15 AND been to see you last week on 9/30. NEITHER of those have been billed to my insurance yet, but i KNOW they will run close to the $750 that we are responsible for.

sb: oh. well, let me look and see what the allowable amounts are for those and i'll call you back tomorrow to let you know what i find out.

that was the MUCH abriged version of that conversation. i've never heard of a doctor's office requiring your deductible to be met before they'll perform surgery. that's just ridiculous. i called my insurance company and they verified that it does happen, although they ask the doctors to not do that. it's all turned out fine (we don't have to pay anything up front) but i was SO upset yesterday that i gave myself a headache.

it's funny to write this now after all the angst of yesterday. it's almost anticlimactic in a way. (that's probably because i'm not feeling homicidal at all anymore.) i did talk to the office this morning and they pulled their heads out of their asses and figured out what the allowable billing amounts were for the 2 visits he's already had and how much of that would translate to our deductible. when they did that our responsibilty comes to $330 which, since it falls UNDER the $500 mark, they don't collect up front.

1 comment:

Stacia said...

Isn't paperwork grand? Glad they got everything figured out now, before you got there. I got Victor's 2nd Heroscape game today, and I'm still wondering if we'll get a third. What ever happened to customer service?