With the maze of paperwork and red tape, I am surprised there aren't more billing errors and communication problems between patients, Dr's, and insurance companies.
Well, this is no miscommunication. This is a giant middle finger to the patient, saying "We can charge this, and so we will".
No doubt. Back in the day, you go in for surgery and you get one bill from the hospital and insurance probably covered it. Now, everything is billed seperately.....surgeon, anesthesia, radiology, facility, etc. You have to watch for duplicates and really watch for what the hospital is charging and what insurance pays. Both the wife and I have had recent major surgeries. We received bills from her surgery before insurance paid. You have to wonder if they would have been refunded or not had we paid them right away and not kept an eye on them. I feel sorry for elderly or people that just don't have the knowledge to follow thru. It's almost a certainty that they're being taken advantage of.
Another area where people are getting the short end of the stick is with insurance denials and refusals. A lot of things that are denied can be appealed or pre-authorized to get covered. This has to be done by the physician's office, and sometimes they don't let you know that this is an option. It can include treatments, prodedures and medications....and can be as simple as changing a diagnosis, identifying other treatments that were ineffective or better documentation of the problem.
