Is it this hard for everyone??
Here's my latest situation: the headache clinic that I go to does not take insurance, so I pay for my appointments myself and then submit claims to my insurance company. My insurance does cover these visits, which is great. Here's the glitch: the headache clinic is part of a hospital that is in my network. When I get statements from the insurance company letting me know how much they are covering, they always include a "negotiated discount" in their calculations...but the hospital does NOT pass that discount back to me, even though I paid it up front. So insurance cuts a check to the hospital, and then the hospital writes a check to me (which in and of itself seems weird, given that I'm the one being reimbursed, not the hospital).
I have emailed the business office director at the hospital under the advice of the nurse at the clinic, and will be following up with a phone call this week. So far, this amount adds up to around $300, and I would really like to have that money in my pocket! Somehow, it seems unfair that just because the headache clinic doesn't take insurance up front I end up paying more for covered services by an in-network provider.
Dealing with ins. and med. costs...again
February 27th, 2005 at 12:19 am