update on the insurance drama

Well, if you read the other post you know that this whole situation is a cluster*^&%.

Today, I called Tricare and talked to the claim people about the whole situation.  Yeah, I know, probably should have done it before this but I was busy and super annoyed.  Apparently, they haven’t paid anything out to the doctor’s office at all.  Why?  Because someone coded the exam too vaguely.  They need it to be more specific.  So I call the doctor’s office because really, a $252 bill 3 months later is the last thing I need.  Doc’s office tells me to call the billing department at another number.  I call the billing department, leave a message (because really, no one answers the phone anywhere).  Billing calls back.  I explain the situation to her, she resubmits the claim to tricare as we’re speaking (look they CAN do something quickly when they want money).  I tell her exactly what tricare says to me, the coding is too vague and they need it to be more specific.  She can’t even see the lab tests on there.  She tells me to call the doc’s office (again?!).  I call the doc’s office and explain it to them again, they attempt to tell me to call billing again but I was quicker than they were!  I tell them I’ve already called billing, they told me to call them because the chart is coded improperly and my insurance won’t accept the coding.  Oh, and by the way, I’m getting collections phone calls.  Apparently that changes the tune of the conversation and I get sent to Wendy’s voicemail.  Who is Wendy?  Whatever.  I leave a message for “Wendy” or her nurse or whatever, explain the situation for the, eh, 6th time and ask her to call me back…. looks like this merry-go-round isn’t going to let me off anytime soon.


5 thoughts on “update on the insurance drama

  1. Ugh, This happened to my husband while he was deployed. He was injured during training and had to have surgery and then almost 2 years later he was sued by the hospital for not paying his bill. Fortunately you can't be sued while overseas so JAG took care of it for him – just had the hospital rebill TriCare. It was a mess though, going back and forth between the hospital, billing and TriCare. I don't know if it's appropriate in your situation too, but you could try contacting the JAG office for advice.

  2. I don't think it's gotten that serious yet, but I am so glad that the nurse "called" me back (NOT!). At this point, I'd love to have the hospital call me back and tell them flat out… I've called my insurance company and your billing, and then the doctor's office and told them the coding was too vague and they needed to be more specific and they haven't done it properly yet. So maybe THEY can talk to them lol. Hey did you get that package yet? I just want to make sure it arrived. If you hated it, that's totally okay. I really didn't know what to put in there.

  3. I should really check your blog before I post this lol! My mom said she has the package and she's going to forward it to me because I get my address on Friday! I'm so excited to actually see it, she was telling me what's in it and I'm thrilled! Thank you!!

  4. I had this same thing happen with me about a month ago. We havent been in the AF too long but it was the first time in a while that we needed to go to the Docs. I'm so fed up with trying to sort it all out and have it all coded right before it gets sent to Tricare. . .

  5. I'm not sure who's fault this really is at this point. I know that it was coded as a preventative exam (gyno) but that's all they did as far as coding. Which is apparently (and obviously) not good enough. Oh well, I'll make another phone call tomorrow because Superman's at work and I'll call the doctor's office again and leave yet another message for "Wendy". If not, I'm about to start screaming because really, I'm trying to get them paid but they're making it so difficult that I really don't give a damn.

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