Insurance billing issue - wwyd?

[y4m]

To make a long story short, my pharmacy submitted a $3700 bill to my insurance incorrectly. That claim resulted in an EOB that shows insurance paying $0 and me paying the entire $3700. Insurance then later submitted the charge correctly and was reimbursed appropriately. So I'm not actually out anything out of pocket.

Except insurance still thinks I've met my out of pocket max. So they are starting to pay the full amounts to doctors for other visits (ie no copay). In a way I imagine would be a mess to clean up later.

Neither the pharmacy nor insurance are at all easy to work with. Do I fight to get them to fix it? Anyone dealt with something like this before?

[AAM2012]

I would makes few calls to the insurance company. I'm not sure there's anything the pharmacy can do on their end.

[aurora]

I would call my insurance mostly because of your last point (would be a real pain to clean up later). I'd explain what happened and make note of who I talked to and when.

Does your company have an insurance advocate? That might be another person to ask.

[mrsfarmer]

Jun 8, 2015 8:12:13 GMT -5 aurora said:

I would call my insurance mostly because of your last point (would be a real pain to clean up later). I'd explain what happened and make note of who I talked to and when.

Does your company have an insurance advocate? That might be another person to ask.

I highly suggest the bolded.  I'm the HR rep at our company and I deal directly with our broker to get stuff done like this.  They have a lot more pull to get things corrected.

[Deleted]

Id make a call to my insurance company and see if they'd fix it...beyond that, I'd do nothing.

[y4m]

No insurance advocate--although that sounds awesome!

I'll give it a week to resolve itself and then try calling the insurer. Thanks for the feedback

[polarbearfans]

I would call a couple times tying to resolve it. Beyond that I don't know how much time/effort I would put into it. Def set aside the money you owe

[fallriverjenn]

Just put the money aside, the bills will come. The insurance will l just issue take backs automatically on all that money to the docs...it happens all the time.

[mich1]

Don't worry.....they'll correct it.

I had the exact same thing happen as well, only it was with an outside lab, not a pharmacy. It took a couple months before the insurance caught up.

[sunshineluv]

I would just wait it out, and make sure I had the money to pay the bill when it does come. No way would I call them about this, too much hassle.