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?
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 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.
Post by fallriverjenn on Jun 8, 2015 18:28:36 GMT -5
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.