But we have to pass the [health care] bill so that you can find out what’s in it.- Nancy Pelosi
American health insurance is frustrating. Historically, whenever I get a bill I make sure that it shows some amount of insurance coverage (to make sure they billed my insurance) and then I pay the remainder. I've always had a slightly more expensive PPO, so I'm used to $40 copays on blood work and that sort of thing. I had exciting copays back when I got my 20+ cavities filled.
Now a baby is really exciting thing from a medical bill and insurance standpoint. We got sent an initial hospital bill and after insurance adjustments it was quite reasonable. I'm not going to say cheap, but at least it was close to what our insurance said it would be. Then we got a second bill for the anesthesiologist and it was expensive. Insurance had only covered about 20% of the bill. That made me sad, but we begrudgingly paid. Then we an updated will for the delivery and the price we had to pay showed four times higher than the first one. It moved it out of the reasonable realm.
So for once, I decided that I shouldn't just blindly pay things, and I gave insurance a call to check it out. Both bills had mistakes. Awesome!
The anesthesiologist? There is a contractual obligation from the hospital that there is a maximum cost. So insurance covered that maximum cost. The hospital than incorrectly billed us for the rest of it.
The delivery? When the hospital sent the updated bill to insurance, insurance incorrectly marked the entire bill as "already paid" and didn't cover any of the new items. The hospital than billed us for the full price of all the additional procedures.
Here, at least, is the good part. Insurance apologies and said they would follow up with hospital to have it fixed and should be getting an updated bill. Was I going to trust insurance to do this? Nope. After I hung up with insurance, I started gathering paperwork together so that I could repeat this conversation with hospital just to let them know why were late on all these bills and to see if they wanted to do anything. Before I had a chance to call, my phone rang again. Insurance called me back! They said they had talked with hospital and both bills would be updated and re-issued and there was a credit that hospital would reimburse us. Awesome.
Anyway - that was Blue of California. Good job guys, you impressed me! You get a thank you letter written to you!