Thursday, September 15, 2011

Doctor's Bills and Hot Flashes

If you remember back to last month, South County Boy went to the doctors so he could get his mandatory 6 month check up for his prescription medication renewal. Since we haven't made the leap to put him on my health insurance yet (its cheaper to keep him on his parents plan for now--- even before they decided we didn't need to pay them for his monthly premium!), we called up his Momma to figure out how his high deductible plan worked.

Essentially we discovered that he gets to go to the doctors and not give them any money upfront. The doctor then bills Aetna and Aetna negotiates what we pay for on our behalf... then once they agree, we get a bill that we pay directly to the doctor.

Sounds simple right?

Well don't worry, they messed it up. SCB's Momma (who I adore btw) got a form from Aetna saying our negotiated amount went from down to $93.19 (instead of paying $270.00)... We were thrilled... and then we got the bill and we didn't know if we should be happy or sad.

Our bill was only for $20.00...

I knew it had to be to good to be true so I decided to call and get the "real" story so I didn't have to worry about getting another bill months down the road with all kinds of interest charges or fines when we may or may not have the funds to pay for it. Better nip it in the bud so to speak.

So I called the doctor's office's billing department to figure out what was going on. It took me a few days to call because the first time I called before 5pm my time a recording told me that they were closed. No where on the bill did it say their billing department was on the east coast... The next time I called it was too early because even though the bill said they were open at 8am, apparently they really aren't because my call at at 6am should have worked perfectly making it 9am in the east coast.... So I waited till a day I worked the gym so I could call them at 1pm when I got off.

Once I got through the line the billing assistant put me on hold for a minuet... and then told me she'd be a bit longer  so she could finish her email... yup, she told me I apparently called right in the middle of her email and she'd be with me in a minuet when she finished it.


When she came back on the line and I told her that we got a bill in the mail for $20, but a form from the insurance company saying our negotiated rate was higher. As she was looking up our account information, she started talking about how she was having the worst bout of hot flashes...

no joke. She went on for a few minuets about how either the heater was going off and on full blast at her station or she was just really getting into it with her erratic hormones. (go figure the one time I don't get a recorded message saying "your call may be monitored for quality assurance" I get a crazy lady who needs to learn the meaning on over share).  

Eventually though, she did tell me that the doctors office just didn't wait for the insurance people to finish negotiating our rate and sent us some random billing amount for the time being. Thankfully our account was correct in their data base so i was able to pay our bill over the phone.

We ended up paying the $93.19 that we owed. Now that that's out of the way, we can move on to our next SCB Health project... The dentist. The man hasn't been in years and has at least one cavity... Guess what he will be looking forward to when he gets back from our honeymoon?


  1. Sounds like they just charged you the standard "copay" amount before waiting for the real balance. I've got an HSA and have encountered similar issues a few times. Although, I've never had a customer service rep tell me about her hot flashes...

  2. That's good that you called. My BF just went to the dentist after not going for years, it was not good. He had to get around 6 fillings!

  3. I'm surprised they even talked to you at all without a hipaa release.

  4. A Hipaa release? I'm going to ask the dumb question... What's is that?