It’s fairly standard procedure: you call, make a doctor’s appointment, go see the doctor, give your co-pay and viola, you are all set. However, as I found out between a million calls to my insurance carrier and a medical biller for my dermatologist, getting anything done was akin to being able to squeeze blood from a turnip.
I had two cysts on my skin; one on my arm and another on my leg. When I went in for an initial consultation with my dermatologist, he instructed me to make an appointment for minor surgery to have them removed. Simple enough right? So, I made the follow up appointment, went through the surgery and gave the receptionist my co-pay and figured it was all said and done. Then, about 2 weeks later, I received a bill for $1,453.91.
“What?” I said, and immediately jumped on the phone to speak with the biller at the dermatologist’s office. She informed me that my insurance company had not sent over the referral from my primary care physician and subsequently denied the claim. Naturally, the next step I took was to call the primary care physician. This was late on a Friday afternoon.
“You have reached my voicemail system, please leave me a message and I will return your call within 2 hours,” said the nurse for my primary physician: I left voicemail. Two hours passed, with no phone call from the perky nurse on the voicemail message. I waited, and closing time came and went, still no phone call.
Monday came around; I called the doctor’s office again, and got the same voicemail. Rinse and repeat, wait some more, no phone call. I called two more times that day receiving the same voicemail and same result. Finally, I called the receptionist desk and explained my plight. The somewhat annoyed voice on the other line assured that my insurance company would receive the referral that same day. They did not, even after I called to verify on three separate occasions.
Tuesday: rinse and repeat again. This time, finally, I met with a little success. I spoke to George-apparently the gentlemen in charge of referrals–, who let me know he had just faxed in the referral form with the correct dates to my insurance carrier. Naturally, I called my insurance company; low and behold no form. I called George back…voicemail.
Wednesday: I called George again. George said he sent the form back over. This time, the phantom form appeared in the insurance carrier’s fax machine. Step 2 was complete. Now, all the insurance company had to do was send the referral form back to the dermatologist, the dermatologist office sends the insurance company a bill and everything should be hunky dory, and my balance cleared.
Much to my chagrin, everything was, indeed, not hunky dory. After two weeks of back and fourth with the insurance company who just could not seem to get it together and make the form appear at my dermatologists office, I went back to George, visited the office, physically picked up the form and brought it to the dermatologist. Another week goes by and the entire mess was finally resolved and I had narrowly avoided being turned over to collection for an unpaid medical bill. Overall, it took 67 phone calls, 30 voicemail messages, $5.37 in gas money and a grand total 13 broken promises.
What did I learn here?
1. Never go to a specialist without a referral form, in hand.
2. Be persistent.
3. Don’t expect much from your insurance company when it comes to customer service.
I hope that by implementing these lessons in the future, I can reap the benefits of my insurance, without the consequence of utter incompetence.