Psycho-Babble Social | for general support | Framed
This thread | Show all | Post follow-up | Start new thread | List of forums | Search | FAQ

Insurance Company Purgatory

Posted by mair on November 8, 2002, at 16:56:08

My pdoc practices in an adjoining state, but she is a provider with my insurer so she bills me only for my co-pay amount and only after she's been paid by my insurer first.

My therapist used to practice in the same adjoining state, but now practices nearer to where I live. (I live in a town which is on a state border) She is not an approved provider. I pay her and then seek reimbursement from my insurer by submitting my own claim.

I've been trying for about a year to get one claim paid for services rendered in November, 2001 when my therapist was still practicing in this adjoining state. My insurer screwed it up a couple of times because it seemed to confuse them no end that she was, at the time the claim was submitted, practicing in one state, but she was practicing in the other when the services were rendered.

Anyway, they finally just sent me an Explanation of Benefits which clearly indicated that what was owed to me (actually slightly less) was paid directly to my pdoc, NOT even to my therapist who actually provided the service. The 2 are not in practice together, nor have they ever been. My pdoc hasn't cashed the check, but she can't quite figure out what she should do with it. I don't want her to pay it over to me because it's not the right amount anyway, and I have since resubmitted my claim for the umpteenth time.

Lately something seems to happen with every one of my claims - I'm pretty convinced that my insurers thinks that if they keep screwing up my claims, I'll just stop filing them. That strategy may work - I do sometimes question whether therapy is worth the aggravation I go through to get reimbursed, and I find myself mentally taking the insurance company's side and feeling apologetic about the high cost of my therapy. Lately, my company has been paying out more in benefits than my family pays in premiums on an annual basis, and they're forced to do this because my group policy is "unmanaged" mental health care.

I feel pretty guilty about this, but also very worn down with all the benefits screw ups.

Just a rant...
Mair


Share
Tweet  

Thread

 

Post a new follow-up

Your message only Include above post


Notify the administrators

They will then review this post with the posting guidelines in mind.

To contact them about something other than this post, please use this form instead.

 

Start a new thread

 
Google
dr-bob.org www
Search options and examples
[amazon] for
in

This thread | Show all | Post follow-up | Start new thread | FAQ
Psycho-Babble Social | Framed

poster:mair thread:32049
URL: http://www.dr-bob.org/babble/social/20021106/msgs/32049.html