The insurance game

Yesterday began with a ridiculous conversation with a hospital and my insurer. The hospital treated me last year for a bullet wound. I gave my insurance information to the hospital, paid my co-pay, and thought it was a done dada.

Then I get this random $58 bill on Friday, about a year and a half after being treated.

The hospital’s bill does not say what it is for. It just says, “Your responsibility: $58. Pay us. K, Thanks.”

I call the hospital:

Hospital Billing Rep: “Hello! What’s your name, social, date of birth, and favorite soda brand? How can I help you?”
Me: “I have a bill for $58.”
Hospital Billing Rep: “What is it for?”
Me: “I dunno, you tell me.”
Hospital Billing Rep: “Oh, your insurer must have denied coverage for a test. Get on that. Call them. Call us back.”
Me: “Mmkay.”

So I call the insurer. Get transferred around, and finally reach someone:

Insurer: “Hay!”
Me: “I have a bill from a hospital.”
Insurer: “What is it for?”
Me: “They don’t know. They said to call you.”
Insurer: “Hm. We probably denied it because you had another insurer! Did you have another insurer?”
Me: “No.”
Insurer: “Hm. Let me look into this matter further. Listen to Muzak for 10 minutes. Brbz.”

I then wait.

Insurer: “Hay! So, we figured out the issue – the doctor didn’t substantiate why a test was necessary.”
Me: “Yes, we dealt with that issue a few months ago. The hospital supplemented the records right?”
Insurer: “Yes. I see those here now! What a surprise. Well, we will get this to our super-special resolution team. It will take at least 15 days for them to give you a decision and 30 days for us to notify anyone in writing. You should call the hospital so they don’t send your ass to collections. Kay? PEACE!”
Me: “Okay…”

I then call the hospital back.

Hospital Billing Rep: “What did you find out, cupcake?”
Me: “They denied coverage initially because the doctor didn’t prove the test was necessary.”
Hospital Billing Rep: “Yes! I see that here, but we sent the supplementary files to the insurer months ago.”
Me: “I know. And they just realized it. So it will take 15 days for a committee to figure things out and at least 30 days for them to notify you in writing.”
Hospital Billing Rep: “That’s ridiculous.”
Me: “I know.”
Hospital Billing Rep: “Well, thanks for calling us back. You should check in with the insurer every two weeks anyway or pay us because we won’t hold your account and might still send your shit to collections. Have a great day!”
Me: “…thanks.”

I’m officially the middle-man here. Ugh.

I could just pay the $58, but I don’t want to subsidize incompetence on principle. We’ll see if a collector starts calling before the insurer figures it out.