[tri-med] Re: Need to vent

Nicole,

Welcome to the Big Dipper Roller Coaster...watch those
loop-de-loops, they can be real stomach turners.

Best advice I can give you is.....

DON'T pay the hospital ANYTHING, regardless of what they
may say.  Getting it back later, after the insurance pays
them, which they probably will, when the right code is
submitted, is even more of a total frustration.

I still have a doctor, who owes me a $125.00 refund, for
Thom's care, from August of 2000.  I will NEVER see it.
At one point, he even tried to get more from me, and
threatened turning it over to a collection agency. I did
manage to get that part fixed, but his billing department
wrote off my refund. How do you even do that...write off
what YOU owe someone else?  Seems to be a pretty common
occurrence for medical facilities though.  It's happened
to me at least 3 times now over the years, and by 3
different entities.

My initial mistake with the above doctor, was assuming
he'd bill in a timely manner, and his bill would fall
into the annual deductible that we still owed for Thom.
But he didn't, and it didn't...

Then something about the insurance check supposedly was
lost in the mail.  By the time it was finally reissued,
the billing agent I was dealing with was fired after
promising me my refund, but before it was issued.  Dr
then changed billing services.  And, and, and...

I finally gave up on it in 2002, after Miss P went in for
her "cardiac surgery from hell", and Lara ended up with
post traumatic stress syndrome simultaneously.  I just
COULDN'T deal with that too. No amount of money would have
been worth the agony....

Another little tidbit for you. I just loved (NOT), reading one
doctor's notation in Miss P's medical records. It regarded my
having told him, "Philina doesn't qualify for PT through her
school, because she doesn't have CP."  The way HE worded it,
made it pretty clear that HE thought I was a few cards short
of a full deck.  (Okay so maybe I am, but...)

While her school DID offer PT, it was a California Children's
Service's clinic, and only for kid's with certain dx's, like
CP.  And of course, my child not only DIDN'T have one of THOSE
dx's, she didn't even qualify income-wise for CCS.  Sooooo,
best watch your wording on what you say to people who will be
writing it down in Sierra's permanent medical records.

I also try VERY hard to ONLY deal with preferred providers, &
PPO insurance, because there's less of a chance of them
actually later denying something they'd previously approved.
There's also less chance of a preferred provider coming back
later and successfully collecting from you, anything the
insurance doesn't pay them.

Fawna, mom to Thom (& Rhonda), Lara, and Philina, 21 yrs
(PT6p & Moya Moya Syndrome), wife to Doug, 10 >^..^<,
3 llamas, 2 African leopard tortoises, & 1 musk turtle,
Philina's Pharm Bengal Cattery, Escondido, CA.
http://home.mindspring.com/~fawna33/index.html
~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~
Can it be a mistake that "STRESSED" is "
    DESSERTS" spelled backwards?
~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~

>Back in May Sierra started getting OT/PT/Speech at a
>even hospital...it was ordered by the doctor.  Before
>we started going, I called the insurance and they said
>?yes it will be covered, she has no restrictions on
>therapy?...I get a bill in the mail for $3,000.00 from
>the hospital for services done in June.

>...So here we sit $15,000.00 in the hole...they will
>only cover certain services with a certain dx...they
>would cover therapy for hypotonia, that and only that
>was supposed to be the billing code when it was sent
>into insurance...Well, the hospital took it upon
>themselves to list out all of Sierra?s dxs...Right now,
>we are waiting for the hospital to change some things on
>the claim and resend it to insurance and I have to call
>back in two weeks to see what happened with it.





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