In May, we went to Englewood Hospital to deliver our first baby. I was all ready to prepare for insurance woes, trust me - I heard crazy horror stories. We did the pre-registration bit, made sure they accepted our insurance (which is a very good one) and spoke to all the doctors to make sure they accepted our insurance as well.
When we arrived at the hospital and my wife was settled in the delivery area, they asked me to check her in with registration. When I did that, I asked over and over again, will my insurance be accepted, do I have to worry about specific doctors not accepting our insurance and so on. The person there reassured me that any doctor who sees my wife or child will accept my insurance. Of course, I was skeptical.
In any event, as people came into the delivery room - I questioned them, in terms of insurance questions. They all accepted the insurance and assured me of that. So I thought I was pretty good, until a month or so later where I got hit with a bunch of bills that I owed money. Most turned out okay after I had to hound either the hospital, doctor or insurance company to get on the same page. I paid my deductibles and the insurance company covered the rest. I said most...
One network of doctors did not accept my insurance. The Englewood Hospital Pediatricians or the group Englewood outsources to for the pediatrics work, did not accept my insurance. So when I get this bill and it says something like we do not accept your insurance, I was upset - to say the least. To be fair, it wasn't tens of thousands, but it wasn't a few bucks - so it didn't break me.
I called the insurance company and they explained that they put the amount towards my out of network. As per my contract, they can't do much more than that. I then call the hospital and ask them why these out of network doctors saw my daughter. The hospital told me, there were no in-hospital doctors available, so they used this group. The hospital told me to take it up with the insurance company or the doctors. Since the insurance company couldn't help me, I tried to call the doctors. Instead, I get a billing service, hired by the doctors, who can't do anything but tell me I owe the doctors money.
The conversation with the billing company was interesting... I'll try to describe how it went, but keep in mind, this was months ago.
* I ask what can be done about this charge, I was told no doctor would see us if they didn't accept insurance.
* They say, the doctor saw you and we had to bill. Take it up with the hospital or insurance company (see the finger pointing).
* But I asked again, why did they see us if they didn't accept our insurance.
* They reply that they have to see all patients, no matter what insurance they take.
* I then asked, do you get these complaints often?
* They reply, all the time, every day, non-stop.
* I then ask, do the doctors know you get these complaints? If not, you should tell them, and maybe they can do something about it in the future?
* We can't tell them, they responded.
* Okay, so can I call them, what is their number?
* They reply, "we can't give you that information."
* So how do I complain about this invoice and their service? I ask.
* They say, "you complain to us."
At this point, I take a step back and try to understand this. I ask them... If you get these questions all the time, why won't you tell them this? They have thousands of unhappy "customers" and they don't care? In fact, three different pediatricians saw my daughter. First one saw her when we didn't even know (i.e. I didn't approve it). The other two introduced themselves as "doctors who work for the hospital." That was on day two and three, so I wasn't thinking straight and I thought, they were employed by the hospital and not outsourced.
* I asked, why do the doctors say they work for the hospital? It makes it sound like they would accept my insurance.
By this time, the person on the other end of the phone is really not happy with me and begins to get short with me. I try to calm her down and explain my situation. I try to get her to understand how evil this sounds. A doctor(s) knows that virtually everyone they see (I think they don't accept any insurance) will have a complaint about the bill. The doctors either (a) see your daughter without your knowledge and (b) imply they are with the hospital so you think they accept your insurance and they bill you. They know you will have an issue with the bill, so they hide it from the onset. I explain this to the billing company and they finally agree with me but say they cannot do anything. Nor can they give me the information for these doctors.
So I do some searching and cannot get a real phone number or address. Of course, I have the doctor's names, but I really am too kind and I decide not to call them at home (yea, I can get that info if I wanted). I can also name the doctor group here and their personal names, but I won't.
I decide to go back to the insurance company and file an appeal or something.
This week, I get another bill from the billing company for these evil doctors. I decide to call, ask if they are willing to accept the amount my insurance company believes they should pay. They do and I pay them in full.
The doctors who checked the health of my new baby, also take advantage of people when they are in a very unpredictable place.
Thankfully, my bill wasn't too bad. I have heard stories of bills for tens of thousands of dollars.
It is just so evil.
(Oh, and if you knew how much I paid for insurance it would make you sick.
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