Wednesday, December 5, 2007

Money Grab

Some things you just kind of have to wonder about. During the summer, I got a bill from a laboratory for blood tests performed back at my physical exam in January. It said it was for the amount unpaid by my insurance company. That struck me as odd, since routine blood tests are supposed to be fully covered by my insurance -- and labs providing those services are supposed to accept the insurance payment as full reimbursement for those services.

So I called a customer service rep with my insurance plan, who couldn't understand why I was being billed, but said he'd rerun the bill through the payments folks. In the meantime, I sent the bill back with an accompanying letter to the laboratory saying I didn't understand why I owed them money and said I wouldn't pay unless I got an explanation.

All I kept getting was past-due notices and threats to turn the bill over to a collections agency. I called the laboratory customer service rep, who said she would look into it and get back to me. I never heard back. Finally, in fear of a bad mark on my credit report, I paid the bill with an accompanying letter of protest saying that I didn't understand why I owed them money. Apparently, they had passed my bill on to a collections agency because, shortly after I sent the payment off, I got a notice from a collections agency telling me I had to pay, plus interest. I sent a letter back explaining I already paid and didn't think I owed anything in the first place.

Well, I sent copies of my original letter protesting the payment to the superintendent of insurance, attorney general's office, my health plan, and the human resources department of my employer. My wonderful human resources rep followed up on it and called last week to tell me they agreed I shouldn't have paid anything and would send me a refund. We'll see if it shows up.

All of this boring detail leads up to my wondering if this is a scam by health care providers to try to collect more money than insurance plans are paying them. I already had paid a bill from the office that did my bone density scan, even though it didn't seem to me I should have owed them any money. But that bill was $10.99, and the lab bill was around $56. Plus, I had the time to question it and the annoyance from the other bill to make me want to fight it.

I have to wonder, though, if these billings are not mistakes, but are deliberate. After all, I drew the bill to the company's attention and pointed out that I didn't think I needed to pay it. They never replied and just kept sending bills. I wonder how many people have experienced something similar, and how many just shrug and pay the bills without questioning them. Insurance, after all, is a complicated business and it's sometimes hard to follow what is covered and what isn't and what you owe that your insurance doesn't cover. I have had other friends reporting similar experiences.

So, everybody out there who thinks the current health insurance system works well for the consumer, raise your hand.

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