Insurance has never been something I like to mess with, but unfortunately, due to medical conditions and pregnancies, insurance has become a very necessary but disliked part of my life. Although insurance can be an extreme hassle to deal with, it saves quite a bit of money out of pocket, and for that, it is worth the hassle!
When I first became pregnant with my third child, I had private insurance through my husband’s work. However, this insurance carried a higher deductible and out-of-pocket, so my husband and I decided to apply for medicaid, a government health insurance program that helps cover the medical expenses of pregnant women and minor children. We were approved, and medicaid was now our secondary insurance.
Early on in that pregnancy, I had some severe abdominal pain. Fearing for the worst, I went to the emergency room, only to discover I had cysts on my ovaries that had ruptured. These cysts were the cause of my pain. Although my situation was medically resolved, I received a bill several weeks later for over a thousand dollars! I was extremely confused by this bill, since between my private insurance and medicaid, the entire amount should have been covered. I called the hospital asking what was going on, only to be told that they just hadn’t finished the billing process yet and to disregard the bill.
A few weeks later, I get another bill for the same amount, with a late fee attached. I didn’t think much of it, thinking that the issue still hadn’t been resolved, however, when I got a third bill, I called the hospital again. I was told they were having issues getting insurance to pay. I made a point to make copies of my insurance cards and mail them to the hospital. Even after mailing these copies, I still kept receiving bills with more and more late fees being added onto the initial amount. Again, frustrated, I took my insurance cards into the hospital’s billing department and watched as they made copies and entered the cards into my file.
I stopped getting bills, and thought the issue was resolved. Then, I started getting collections calls. These calls would come at all hours of the day, sometimes as many as three or four times in a single eight hour period. The calls began at 7-8am and didn’t cease until 7-8pm each night. I tried explaining the situation to the collection agency, only to be greeted with condescending, rude and even disrespectful language. I was told “Just pay your bill and let insurance reimburse you later.” The collectors didn’t seem to understand that medicaid doesn’t allow for that practice, and I can’t pay a bill ahead of time and wait for reimbursement if I don’t have the money to pay the bill. It just wasn’t possible.
I started getting really stressed out. I was dodging phone calls, while continually calling the hospital, trying to get my account sorted out and insurance billed correctly. I couldn’t even answer my own phone anymore unless I recognized the number on caller ID. I couldn’t stand it. One day, after an especially rude collector had me in tears, (I mistook his Minnesota number for my dad’s phone number), I went to the hospital armed with the bills and my insurance cards.
After arguing, and expressing how unhappy I was with the whole situation it finally came to light what the real issue was. The billing department had billed medicaid before billing my private insurance. Medicaid will not make a payment on a claim until the primary insurance has paid their portion. I was then informed that they had no control over how this collection would affect my credit, and that I would still owe the collection agency their fees for collecting the debt, even after insurance was re-billed in the correct order. I was outraged! Not only was my credit score damaged, but I was expected to pay a 25% collection fee as well, for a mistake the hospital made? After getting severely angry and speaking to a few higher-ups, the situation was resolved and I did not have to pay anything on the so-called ‘delinquent’ account.
Although the situation was resolved, it was a huge nightmare. I was so stressed about the entire thing. I spent months unable to determine why insurance wasn’t paying what they should, only to discover the hospital (who should know how to properly bill medicaid and private insurances) had made a mistake. The entire situation was a nightmare.