Health net of Arizona was provided to me as a company benefit in 2000. Health net was to pay all medical bills sent in by my physician’s office. The medical office I utilized was Sonora Medical plaza. Many Tucsonan’s on health net had given it the nick name Health nut. I was about to find out why.
Customary costs are a word we all need to know. These are the normal fees a Doctor in your area may charge with respect to all other providers who charge the same fee for the same procedure in that specialty. One of the benefits Health net program offered without cost to the customer was a yearly physical exam.
The physician I had at that time charged $120.00 for a yearly physical. The exam usually lasted less than ten minutes, without any labs or body fluid collections.
There was no co-pay and the Doctors office never called me after the appointment. My first clue something was wrong came in the mail. When I received a past due notice with the usual credit threats to destroy my rate if I did not pay what was owed, that was in February 2001
Quickly seizing the phone to call the eight hundred numbers provided with my health net booklet in hand. The operator came on and identified herself to me as Kim. We proceeded with the usual greeting and information she needed. She asks for my name, social security number, birth date, address and phone. Then Kim said, “How may I help you today.”
I began by letting her know the account number. Quickly I asked Kim, “does Health net provide without cost to the customer one yearly physical exam?” She responded with, “yes.” I began again, “then why am I holding a bill for $120.00 that was denied and I am just now receiving it 90 days past due. With my credit rating in jeopardy I want to know how we may resolve this issue today so my credit is not harmed and your company has paid my doctor.” Could you tell me how we may proceed?” Kim responded with, “I am sorry for this Mr. Jasper it looks as if you had two physicals this year, one back in January 2000 and now in December 2000. Your Doctor has been provided payment for the first physical but as for this one we must charge you since we only offer one a year.”
Of course Kim had no idea I had been with Health net a mere six months and had no insurance prior to that. Once armed I let her in on my secret, I stated, “Kim I signed on the plan six months ago and had no insurance with your company or any other prior to this, could you explain why then I am being told my Doctor was paid for an exam you say I had in January when she was not my doctor at that time and I had no insurance from your company?” Kim responded, “May I place you on hold for few moments while I investigate this.” Of course I said.
Kim came back and apologized to me for the wait. She informed me I had nothing to worry about and the issue had been resolved. I wrote the code down she gave for future reference and we parted ways.
March 2001 I received a collection notice from Black-hearts collection agency. Demanding I pay the previous debt of $120.00 plus their fee of $59.00. Now on my credit report and previously being told all would be well I was furious. Now I was wrapped in rage with an uncontrollable desire to destroy Heath net and their corporate conspiracy against mankind.
Thank god for a clear headed wife. My spouse called all the parties necessary and within two days she had resolved the issues. We had copies of all letters and apologies from persons at both ends of the corporate conspiracy. Health net in their wisdom had never taken off the erroneous report regarding the first physical, they never followed up. My wife took control she faxed my sign up sheet which clearly showed what date I had been insured. Once Health net apologized and sent her copies of letters showing I owed nothing. We faxed these documents to the collection agency. We requested they notify my credit bureau and send a letter showing I owed nothing. The collection agency took over two months to resolve with weekly follow up calls. After one half year we were able to close this chapter in our lives.
