Monday, July 09, 2007

A new Road Trip from Hell -- Michael Moore is right!

I survived the trip back from DC. Now I am dealing with the paperwork which piled up in my absence. Among them a doctor's bill.

Yesterday I saw the movie Sicko which is Michael Moore's latest. It is a scathing indictment of the political establishment, the pharmaceutical industry, the health care industry, but mostly of the health insurance industry.

Today, I had such a run in. First, it is nearly an act of God to talk to a person, and that after punching in series of numbers including your "ID." (Of course this is not a number which you can find on any document from the company!) Then when you finally get a real person you have to tell them all the very same information which you have just punched into the phone seventy-two times.

I was calling because the doctors office had billed for two things. One of which (because I have an HRA to cover the deductible), I have a check for, and have been waiting for a bill from the doctor's office for several months.

The second item I had asked about in May (for service provided in February), and was told then that everything had been paid directly. The doctor's office, of course, said that they billed because the insurance company had refused to pay.

The insurance company says something like "the procedure was not appropriate for the diagnosis." Of course, it was some clerk saying this about a test that a Medical Doctor had ordered. Probably what happened....somebody used the wrong code, most likely because this insurance company is in a different region than the doctor.

Ugh. I hate this. Michael Moore was right!!!

1 comment:

  1. I hear you, Michael. I have been billed for things I thought were covered by my insurance more than a year later. How am I supposed to remember what X-rays I had taken 18 months ago?

    I must say both my insurer and the HMO that covers me have been pretty good about having me talk to a live person.

    I'm sure you've heard of Kaiser Permanente HMO. I had been with them for around 40 years. I couldn't make an appointment for a physical with my primary doctor. Finally, I got disgusted and at open enrollment asked for a new insurer. To make a long story short, I might not be here had I waited for Kaiser to allow me to see my doctor. At the new HMO the doctor ordered a mammogram. As it turned out, I had a cancerous lump. Surgery, radiation, and chemo followed.

    ReplyDelete