Persistence Pays Off

For the past 5 months, I’ve been fighting what seemed like a losing battle. I’ll admit, there were several times I wanted to throw in the towel. In the past, I probably would have. What am I talking about? A $600+ billing error.

It all started back in August, when the results of my annual exam came back with the dreaded “abnormal” status. My doctor suggested that they send the original samples out for further testing before proceeding. My other option was to have a biopsy. Hmm… further testing, which involved me doing nothing? Or biopsy? Is that even really a serious question?

Luckily, the second results came back fine. I was told to have a recheck in 6 months. I felt like I was home free! Until I got the bill from the lab: $650, and a notice that my insurance had denied the claim. What?!?

So, I called the insurance company. The lady on the phone was super sweet about it, and very helpful. It turns out the second set of tests was coded as “routine testing”. Since those tests aren’t routine, the insurance company denied the claim. They should have been coded as “diagnostic”. No big deal, it happens. She even called and left my doctor’s office a message that they needed to resubmit the claim with the correct coding. As it turns out, the doctor’s office codes it for the lab, but the lab that does the test is the one that was billing me. So, I called and explained the situation to the lab. They were super understanding, and said they would send me a corrected bill once everything was sorted out. Easy-Peasy!

Except it never works that way, right? A month later, a bill from the lab came in the mail for………$650. I called the lab, who said they never received the corrected orders from the doctor’s office. I called the doctor’s office: Sure, sure, they’d resend the orders. I called the insurance company, who basically said there was nothing they could do until the doctor’s office sent the corrected orders to the lab, and the lab sent the corrected claim to them.

This has gone on for the last 5 months. The doctor’s office, the lab, and the insurance company all admit that the problem lie in that one little code. The doctor’s office freely admits that it was their error. The insurance company freely admits that it’s a claim they will cover, just as soon as it’s coded correctly. Round and round we go. Phone calls, and letters, all culminating in a letter from the lab stating that I was being sent to collections. Ugh!

I’ll admit that I was tempted throughout this process to just cut them a check for $650 and be done with it. In the past, I would have. I can’t tell you how much money I’ve wasted in the past on incorrect bills, just so I wouldn’t have to deal with the hassle. What kept me from doing that? Honestly, this blog. Paying out $650 would have a noticeable impact on my monthly net worth numbers. Suddenly, for the first time in my life, I have accountability to someone else for where my money goes each month. How can I justify spending $650, just so I don’t have to deal with a problem? So, I trudged on. Phone call after phone call, each one stating it would be taken care of, each month getting a letter that it hadn’t.

And finally, at long last, the problem seems to be resolved. I’ve been checking my claims on my insurance company’s website, hoping that eventually the “denied” claim will be updated to “approved”. Since the insurance company should process the claim before the lab creates a bill, the website is the first place I’ll see that something has changed. And finally today, it did! My $650 “denied” claim has been changed to “approved”! According to the website, I only owe $12 now. Whew!

Of course, now I’ll have to wait and see how this all plays out on my credit report. I’m not sure yet if the lab did actually send me to collections. Even if they did, now that it’s all been fixed, they should send a report stating the initial collection was incorrect. I figure I’ll give it a few months and then check to make sure everything is corrected. If not, well, there’s another fight I’ll need to take on!

– Cindy W.

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