Well, Still Fighting the insurance. . . . UPDATE! See Latest Post By Me At The End.

Sorry to hear this . Its aggravating I know , my daughter had a problem awhile back and the ins company had to ok a procedure , it took them almost 2 months to do that . I went to the docs office raising hell trying to find out what was taking so long . When they told me , I said people could die waiting around for these stupid ins companies to authorize this stuff . They ought to have an ins employee work in the docs office and deal directly with the doc . This reminds me of the movie , Rainman , or Rainmaker , something like that .Good luck .

Aaaaaaaaaaaaaaaaaaaaaah. . .

What if I reported the insurance company to the BBB!?! They wouldn't like that. This company is just "splitting hairs". Both my doctor and her brother OWN the business! So either should be able to submit under the company name! And the company IS listed as being in the network in the providers list! Now we're being told that his tax number is inactive and the company should not still be listed in the book.

BUT WAIT. . . .Guess what I found in the book also. . . .another doctor in this town is listed BUT HE'S BEEN DEAD FOR THREE YEARS!!!! Yeah! They even suggested him and said I could go to him! I said I'd have to DIE first LITERALLY! Then I wouldn't need him or them!!!

The problem with the BBB , is you have to pay to be a member with them. As long as your paying their monthly fee to them their not going to give you a bad rating . I knew a guy that was a member for a while that had a good rating , when he quit paying they dropped his rating .

Whole system is corrupt with no regulation...google "insurance company + denial"..see if they are working in your best interest.

hawgdawg said:

The problem with the BBB , is you have to pay to be a member with them. As long as your paying their monthly fee to them their not going to give you a bad rating . I knew a guy that was a member for a while that had a good rating , when he quit paying they dropped his rating .

Click to expand...

Absolutely true. An old co-worker of mine currently works for the BBB. He had no problem telling me exactly that. Want a good rating, fork it over.

When I had my knee surgery, for some reason my claims were slow to process. So slow that the University of Wisconsin-Madison Hospital started to send me bills. Well, I didn't have $20,000 laying around to pay it.

I call the insurance company, United Healthcare. They say to call the hospital and ask to move it along.

I call the hospital, they say they already submitted it and are waiting for them.

In the meantime, some computer at UW wants their pound of flesh and starts automatically sending out bills. Insurance asks me to fax the bills and I do (more than once). More waiting for the hospital, insurance and the occasional outstanding bill. Well, it finally came to a head when I got one of "those" letters/bills telling me that payment needs to be paid or it would be sent to collections.

Collections? I've had full medical insurance since I started at my job 22 years ago!!!! How can this be??? The hospital even recommended making a "token payment" to send a message the I was indeed going to pay the bill. No f'n way was I going to spend a dime over my deductible, and I didn't. On to more of having the hospital tell me to call insurance and vice versa.

Here's how it was finally resolved, and full credit has to go to the best rep at the insurance company. She asked for the phone number of the hospital and asked to put me on hold. A couple minutes later I was in a three-way call with me, the insurance company and the hospital billing department. Within a few minutes of them talking to each other, it was settled and I was getting apologies from everybody.

Funny thing.....nobody along the way asked me how my knee was doing.

As for the OP, I had something similar happen with my physical therapist and the clinic she worked. The clinic was in-network, but nobody that worked there was. Huh???????
In the end, I bitched so much that I never saw a bill.

Stay on top of it all and stand your ground. They're hoping you'll just give up and pay so they don't have to.

Don't go without your medicine. If you have no other choice just go to the ER and tell them you ain't leaving till you get it. They might write you a prescription but don't settle for that if that won't work.

Dirt Nuker said:

As for the OP, I had something similar happen with my physical therapist and the clinic she worked. The clinic was in-network, but nobody that worked there was. Huh??????? In the end, I bitched so much that I never saw a bill.

Click to expand...

Sorry for all the HASSLE you had but glad it got worked out! I'm hoping for a good outcome on my issue with the insurance company (Humana Medicare Advantage Plan). In the meantime my doctor has told me that all I'm obligated for is the co-pay and she said she wasn't in any hurry for me to pay all of it ($130 remaining after giving her $60). She said pay whatever you can whenever you can. She seemed to say if I get paid by the insurance company, fine; if I don't, fine.

But I'm going to do everything I can in my power (appeal, whatever it takes) to get the insurance company to pay it. THEY ARE THE ONES who told me to go to that clinic as it is listed as being "in network" and now they won't pay saying it ain't! I say that's their fault -- I was misled, misinformed. I wouldn't have gone there if I had known! So I think they should pay for THEIR mistake!

It sucks, because they (insurance and billing institutions) suck. You, are the one who has to put in time and stress to resolve the issue, and you don't get paid to do that either. Stay on top of them. Get them, like the other poster said, to talk to each other. Write letters if need be.

When my son was born, the on call pediatrician's office billed the insurance company wrong and threatened me with collections if I didn't pay their bill. It was a back and forth mess. I would call my insurance and they would say one thing. Next time I'd call the person would say that wasn't right, this is right, etc. FN nightmare.

Hang in there Pennyfinder. Hang in there.

UPDATE! Insurance Agent Pushed It Through . . .

He bypassed all the local levels and went straight to the "TOP DOG" he said. He even went over the supervisors he said! He flat out told them that THEY were the ones who SAID I could go there that the clinic was in network and all I was responsible for was the member co-pay NOTHING ELSE. Then when I went there they backtracked and said it WASN'T in the network! So they are obligated to PAY IT! End of story! So they have no choice but to pay it.