![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
Shall we discuss insurance reform?
Nov. 2nd, 2009 01:29 pmSo.
Surgery performed at covered surgery center. Therefore, all services at the center are covered, even if providers are out of plan.
Out of plan provider bills insurance company. Company covers service. By sending a check TO US. And telling us we will receive a bill from the non-plan provider. And we should deposit the check and pay the non-plan provider's bill.
Now. This is possibly an improvement on the system where invoice comes to us directly from non-plan provider, and we have to pay on demand then request reimbursement from insurance company, because we are never out of pocket.
But isn't there a third option? The insurance company is holding the stupid invoice RIGHT THERE in their metaphorical hands. Why not, oh, I dunno, just pay the stupid bill?
Why all the handwaving and fussing? There's wasted paper and postage all over this deal, not to mention excessive clerical staff on all sides to handle the double mailings.
Top that off by the fact that for MY surgery, back in the spring, we already did this dosido, except, we got the payment, but no demand for payment. Except tha last week we got a demand for REPAYMENT back from the insurance company, saying due to clerical error they overpaid us by ONE THIRD and want their money back.
Now, this is a non issue. ALL the money is still there. *I* have now called the provider to ask would they like their money, please send an invoice. But this does not invoke any kind of confidence in the process, especially because the amount of this payment for Husband is 34 times the small amount I received for my surgery issue. I will be pretty damned pissed if six months from now, they review their paperwork and decide that we own them one third of THIS amount back, AFTER we have paid it to the provider. Who I called to ask that they please send an invoice so we can give them their very large sum of money.
So they have COLLECTIONS involved in this process, too. Due to the fact that they are dealing with us instead of dealing directly with the provider. And what is the point of all this?
It's amazing out quickly you see the problems in the system once you start actually USING the system. The only reason that this reform hasn't happened quicker must be because not enough people are sick enough to use it. Too bad we can't have a giant leg-breaking or something...
And nothing really bad has even happened to us. This is only slightly annoying and I can already point to half a dozen obvious sources of waste in the system - going back to the suggestion that I have three cyst biopsies under general anesthesia.
Truly amazing.
Surgery performed at covered surgery center. Therefore, all services at the center are covered, even if providers are out of plan.
Out of plan provider bills insurance company. Company covers service. By sending a check TO US. And telling us we will receive a bill from the non-plan provider. And we should deposit the check and pay the non-plan provider's bill.
Now. This is possibly an improvement on the system where invoice comes to us directly from non-plan provider, and we have to pay on demand then request reimbursement from insurance company, because we are never out of pocket.
But isn't there a third option? The insurance company is holding the stupid invoice RIGHT THERE in their metaphorical hands. Why not, oh, I dunno, just pay the stupid bill?
Why all the handwaving and fussing? There's wasted paper and postage all over this deal, not to mention excessive clerical staff on all sides to handle the double mailings.
Top that off by the fact that for MY surgery, back in the spring, we already did this dosido, except, we got the payment, but no demand for payment. Except tha last week we got a demand for REPAYMENT back from the insurance company, saying due to clerical error they overpaid us by ONE THIRD and want their money back.
Now, this is a non issue. ALL the money is still there. *I* have now called the provider to ask would they like their money, please send an invoice. But this does not invoke any kind of confidence in the process, especially because the amount of this payment for Husband is 34 times the small amount I received for my surgery issue. I will be pretty damned pissed if six months from now, they review their paperwork and decide that we own them one third of THIS amount back, AFTER we have paid it to the provider. Who I called to ask that they please send an invoice so we can give them their very large sum of money.
So they have COLLECTIONS involved in this process, too. Due to the fact that they are dealing with us instead of dealing directly with the provider. And what is the point of all this?
It's amazing out quickly you see the problems in the system once you start actually USING the system. The only reason that this reform hasn't happened quicker must be because not enough people are sick enough to use it. Too bad we can't have a giant leg-breaking or something...
And nothing really bad has even happened to us. This is only slightly annoying and I can already point to half a dozen obvious sources of waste in the system - going back to the suggestion that I have three cyst biopsies under general anesthesia.
Truly amazing.
