Insurance mess up

By Anonymous Latest Reply 2010-04-06 16:46:23 -0500
Started 2010-04-05 08:21:18 -0500

I don't know if anyone here will know or understand this question. I am just starting to understand whats going on myself. So heres the deal: From June 2008 to August 2009 I had insurance through both my husbands work and mine. Before I had only had insurance through my husbands work. When I went to the doctor during those times I only gave them my hubands work insurance information. I did not know it but that was considered my secondary insurance. I don't if I just forgot or what but at 6 different doctors during that year I did not give them the correct insurance information (I gave my husbands work insurance as my primary and did not give them my work insurance with was actually my primary). Well recently I have been getting bills from those doctors offices for hundreds of dollars. My total for all bills during that time period is now 1,325! I cannot pay that. I spoke with the insurance company that was my primary at the time and they said to have the doctors offices refile to claim with the correct information and to send them "proof of timelt filing". From what I understand my doctors offices are doing this but my claims are still being denied. Am I responsible for these bills even though I had two insurances at the time. I did make a mistake with the insurance information but I cannot pay that much out in bills…that's why I have insurance. Does anyone know anything about this stuff because I am so confused. Thanks for your help.

4 replies

2010-04-06 16:46:23 -0500 Report

I'm one of those people who NEVER give up on the insurance messes, so here's my two cents. The suggestion to find out why they are denying it is good but it's your responsibility to make sure the dr is showing the "proof of timely filing" and that could be where they get you so be relentless! If insur co says it isn't timely, get them to explain EXACTLY what they are looking for and then you evaluate it. If there is no way around their "rule" bc of your oversight way back when, you need a friend at the insur co so that's when the fun begins! Keep going up the ladder of authority until you get some satisfaction, and then do what they tell you. Be sure to take names, badge nbrs, make copeis of what you send them and take notes of each and every phone call so you can stay on top of them. It's not fun, and it's not easy, but it's worth it when you don't have to pay all that money. if you get some feedback that you dont understand, you can write me back and I'll try to help. I'm not in the insurance business, but I have done enough of these to have a good idea of what is going on. good luck!

Anonymous 2010-04-05 21:45:18 -0500 Report

What reason does the insurance give for denying the claim? The reason or code for the reason should appear on your "EOB". After you find out the reason given for the denials argue they should pay by specifically countering the reason for denial otherwise you may be wasting your time just resubmitting the bill over and over again. I once took BC/BS all the way to court arguing that they needed to pay some claims they had denied. I won, but it was not easy and I learned more about insurance then I probably really wanted to know. Good luck.

Harlen 2010-04-05 09:11:53 -0500 Report

Keep sending them in
Its a game they love to play
Been there done that
Best wishes

Anonymous 2010-04-05 13:11:00 -0500 Report

Thanks Harlen, that is what just about everyone who I ask tells me. Insurance is sooooo confusing and frustrating but I have to have it. Thanks for your help. I'll just keep sending them in. :)

Next Discussion: Craft Project »