Monday, March 11, 2013

It pays to be persistant

I received this EOB from my insurance company today. I went to the eye specialist in November. We discussed some of my vision issues, all is well, change your lenses (glasses and/or try contacts again) when it's time to, there is only an ever so slight change in my RX. Great.

I am very much aware of my insurance.  I paid the $25 copay as well as the $50 we don't cover routine eye exams/refractions part of the bill, so I was $75 out of pocket for a $200 charge, insurance will take care of the remaining $125.

My first EOB arrives, dated mid Nov, and insurance won't cover anything. HUH?? They have always covered these visits, minus the refraction fee and co-pay as I have underlying medical eye issues besides being near sighted.

A few weeks later, I was in the same office with college girl, so I asked why this wasn't covered. They check, it was sent to ins. as "routine." I reminded her that since 1987, my eye exams have been billed as non routine, and ins. HAS and WILL cover the bulk of it once again. OK, we'll resubmit, we have to first speak with the MD. If you don't hear from us, no news is good news. Fine.

Fast forward and this paperwork has been sitting in my pending file. "We didn't resubmit yet, the MD has been on a 3 month vacation but will return in March." I've also received a few automatic bills.

Apparently, eye Doc is back and he gave the thumbs up to resubmit with the proper codes to get this covered. First, an inplan discount of $16.64 was applied and then the ins. paid $108.36. The account is now paid in full, and once again, I am out $75 vs the $200 I would have otherwise gotten stuck with.

So yes, I can be like a dog with a bone until issues like this are resolved. I wonder just how many would have simply shrugged their shoulders and paid the $200 invoice.

1 comment:

Belinda said...

Being persistent pays off!