Navigating the Shifting Sands Of Health Insurance Can Be Hazardous To Your Health
posted in Cheap Auto Insurance |It is readily acknowledged that medical services billing and insurance coverage is a complex path to walk. It should be clear what is covered by insurance and what is not, but not only is this difficult for the insured, it can also be a mystery to the physicians billing services. The physician’s visit is allowable but certain tests are not fully covered. The drugs prescribed are sometimes fully covered and sometimes not. The insurance companies can even decide that a doctor is no longer covered under their program, though they have been for the last ten years. Though they are required to tell all the persons involved, this information can be lost in the endless insurance paper chain, leaving the bewildered physicians and their clients to try to figure out the amounts owed.
Clay was regularly visiting his physician for the past five years. The doctor and his patient had worked together to get his asthma under control. Albuterol, an inhaler for short-term symptoms was used. When his breathing difficulties increased, [another steroid breather, Advair was added. When surprised by a severe asthma attack, an emergency room visit was necessary. All of this was, as usual, paid in full by the insurance provider. Two months later when Clay returned to his doctor for a check-up and to get his prescription refilled, Clay was taken aback when the pharmacist told him that the Advair he was required to take for the rest of his life was now going to cost him one hundred dollars every two months.
When Clay called his insurance provider, he was told that Advair was no longer covered under his plan. He he explained that the other medicines didn’t work. They said that this was not their problem. This was the responsibility of physician and patient. Three months later, Clay also received a bill for the entire payment of his treatment and lab tests at the previous doctor’s visit. He called the doctor’s office and was told that the doctor that he had been seeing all these years was also no longer covered under his insurance. When he called the insurance company to complain, their response was that doctors were shifted from time to time and it was up to the medical provider to make sure that you knew that the visit was not covered. When Clay called the billing office he was told, that because he was a continuing client, payment was not required immediately, but billed him instead.
Clay fought the insurance company for years to no avail.. In the meantime, his credit was ruined since his unpaid bill went to collections. There was no compensation for the doctor either, as well as losing a valuable client. Extra phone time and paperwork was required by the billing company, not to mention the stress of working with a dissatisfied and angry client. The ones who didn’t suffer were the ones who understood exactly what was going on and that was the insurance company.