Davita billing refuses to communicate with me

[swramsay]

This is very odd. I've been having problems with my billing for months. I discovered my insurance was paying $1500 for each dialysis session because I was dialyzing in an out-of-network center in Puyallup. When I discovered that, I immediately had them move me a few miles away to Federal Way which is in-network. The in-network rates for Federal Way for home dialysis is $85.50 and in-center is $220. My insurance is paying $621 - far more than the contracted rates. I am now doing home dialysis. I have called the billing department several times. They have been "instructed not to talk with me" with no reason given. They say I need to go through a social worker who will talk with the guest services specialist who will talk with the billing dept. Brother. The social worker will not help (nor would I expect her to) because she believes it's a conflict of interest. The guest services specialist doesn't have the information either and I spend twice as much time educating her on the situation as I would to simply talk with billing myself. Plus a week has gone by and not a single answer to 3 simple questions that I clearly asked.

This is the most frustrating, unprofessional and ridiculous behavior I have ever seen in a corporation of this size. Have any of you had similar experiences?

[David13]

I think this is a case of bureaucracy gone mad. 

That being said, I don't understand how it is a "conflict of interest" for the social worker to try to help.  Social workers deal with insurance coverage issues all the time. 

[monrein]

I agree with David about not understanding the social worker's "conflict of interest".  The social worker's primary role and therefore interest is supposed to be the patient's psycho-social well-being and dealing with what you have been dealing with could cause anyone extreme mental anguish.

I have no advice on the billing issue because we do not confront those in our system but as a former social worker I'd like to know exactly what the job description of your social worker encompasses.  The conflict of interest business sounds like a cop out to me.

Why is the insurance company not dealing directly with the dialysis provider?  Isn't it in their interest to pay less per session....I don't get it at all.  What I do feel very strongly about is that people with ESRD (or any illness for that matter)  and all that it entails should not have billing issues added to our already considerable burden.

Good luck sorting this out.

[Sluff]

I hate dealing with insurance companies and the medical billing departments. Christy handles all of that and it is unbelievable at the double billings and mistakes she catches. All the mistakes have always been one sided favoring the medical billing department. How many people just don't have the patience to deal with these jerks and give up. That is probably what they hope happens.

[willowtreewren]

I find it odd the the social worker considers this a conflict of interest. One of the questions our social worker ALWAYS asks is if we have any billing issues that she needs to clear up.

 

I wish we could send her your way to help out!

Aleta

[G-Ma]

Hey all....my social worker also uses the "conflict of interest" card....no matter what....I would love to see a job description.
I've just gotten to where I write letters, make copies and fax or mail and then follow up...have had no trouble.  Oh, SW does fax these for me but won't look at them...too funny.

[Wallyz]

The conflict of interest is that the Social Worker knows that Da Vita's primary means of squeezing a profit margin is by soaking the Hipper patients by overcharging their insurance companies.  The social worker has a vested interest in keeping her job.