I Hate Dialysis Message Board

Dialysis Discussion => Dialysis: Medicare/Insurance => Topic started by: cariad on July 13, 2012, 09:13:13 AM

Title: How to handle our local Axis of Evil
Post by: cariad on July 13, 2012, 09:13:13 AM

I am referring of course to United Healthcare and Columbia Hospital and would appreciate advice. The only people who have been polite and eager to help in all of this are the good people at Medicare. So much for the theory that government employees are incompetent, arrogant and rude.

This is a bill from over a year ago, so the UH policy was written for Gwyn's former workplace and there is no way that they would back us on anything.

I went to this GP twice. First time was for a general appointment to establish him as my doctor. Second time was out of desperation because I had PHN (post-herpetic neuralgia) and was in agony and he was the doctor I was already with. First time I was unimpressed and alarmed that he had never heard of Prograf. Second time he was so damn awful that I left the place in tears, and my parents were visiting because my uncle had just died, so even they remember how angry and panicky I was after this appointment. He prescribed me a med that two doctors would tell me was an antiquated choice for PHN and would not solve my problem (The PHN was ruining my life, I could not function as I never knew when I was going to be knocked to the floor by this pain.)

So I have received a bill for around $65 for the two appointments. I have never had a co-pay nor co-insurance on GP appointments since I have had both Medicare and private insurance. However, I am being told that I not only owe around $20 per appointment for what Medicare does not pay (it is not a co-pay, it is just the excess on the Medicare bill) but this utter tool is charging me a facility fee. For a GP appointment?! Has anyone else heard of this? When I dropped this half-wit and went to a highly rated doctor through a different hospital group, I again have not had to pay a cent in co-pays nor co-insurance, and this was back on Medicare and UH, still through the former employer. In other words, same insurance coverage, but this is the only person who has said I owe anything.

My father is an erstwhile attorney who has owned his own companies for the past 30 years, so he understands the law and also knows lots about employee healthcare benefits since he has always provided this for his employees.

I have spoken at length to hospital billing, Medicare, and briefly to insurance who said that our policy states that if Medicare pays more than they would pay as primary, then they don't owe anything. They are not primary, so what sort of crap is that? I have been with Blue Shield, Blue Cross, Anthem and United Healthcare in my life, and UH outdoes the lot of them for sheer, unadulterated greed.

I am just angry enough to spend whatever time it takes in the midst of all of the other drudge I have to do to write to whomever I need to in order to not pay this bill. I am thinking of offering the billing office half, saying take it or get nothing, good luck tracking me down after August. Or, writing letters to the state insurance commissioner's office, my local congresswoman, the hospital administrator, director of the billing office, and anyone else to say that I don't believe I should have to pay for incompetence, nor should they be able to charge me for their rent payments. This office had absolutely nothing that would warrant a facility fee. Also, shouldn't facility fees be under Part A? Because they've billed it under Part B and have called it a 'technical fee'. Let's see, he talked to me at length for the first appointment and removed 1 stitch from my biopsy, and the second appointment he demanded to see my leg even though I just wanted a prescription for something that would take the pain away and to get the hell out of there. Ooooh, how very technical of him! :sarcasm;

Any thoughts or similar situations that were resolved in your favour?

Edited to fix a smiley error.

Title: Re: How to handle our local Axis of Evil
Post by: jeannea on July 13, 2012, 01:12:02 PM

I usually lose my insurance battles, esp over which meds are paid for. At my last job, United Healthcare was one of the choices. I agree, they suck. Good luck!

Title: Re: How to handle our local Axis of Evil
Post by: jbeany on July 13, 2012, 06:36:07 PM

Sounds like the local one - Priority Health - aka "Insurance for Healthy People Only."

I may not be the best one to answer this - because the last time I got a $20 co-pay when I knew something was billed wrong, I just paid it.  I didn't have the time or the energy to spend on the fight or the phone.