- 3 years ago
- Wedding: December 2009
Hi bees, I’m a total loss of what to do and was hoping someone here could shed some insight. To make a VERY long process somewhat short, here’s what is happening:
Last May I had an atypical mole removed. I did my due diligence, double checked and made sure the doctor was in net-work, procedure was covered, etc. In the end, Anthem denied the coverage with the reasoning that my doctor was out of network. After going rounds and rounds with them, it was decided I should file an appeal, which I did. I wrote a very detailed letter and included screen shots of my account with Anthem where it said my doctor was in network, included the name/reference number of when I called anthem to double check…I was VERY detailed. In the end, I received a letter from Anthem agreeing with me and saying they would be paying for the portion they were responsible for (I’m on a 70/30 plan).
Between all of this (it took 3 1/2 months to get an answer), I repeatedly checked in with the billing department at the hospital to keep them current on the situation. As a side note, one doctor that was involved (the doctor I had to get the referral from) never turned my info over to insurance, so that’s a whole other issue. Every single time I called, it was like going through it for the first time and each person promising to update my records.
Once I received the letter saying I won the appeal, I sent it to the billing department and called them…practically begging them to contact Anthem because I just wanted to wrap this up. Since then, I have received two to three more calls from them wondering when I am going to pay. Ofcourse by this point, I am pretty frustrated. I was very stern in my last phone call telling them this has been going on for months and I have repeatedly had to explain the situation over and over and no one seems to be following thru.
This brings me to yesterday when I get a call from a DEBT COLLECTOR saying the billing department has sold my debt to them. I was irate. I called the billing deparment, and low and behold they “never received the letter” (I have proof it was delivered) and they have received no communication from Anthem. So, I called Anthem and they claimed there was a “mistake” in their system and instead of paying the hospital, they applied the charges towards my deductible since the doctor was out of network. KILL ME NOW. She said she realized the mistake and was resending it all to the adjustment center and it should be taken care of in 30 days. Ofcourse, I have zero faith that it will be fixed.
But, here’s my real problem. What do I do about the debt collector? If Anthem does what they say, they’ll be paying the hospital, who has sold the debt to a collector. If I pay the collector, I can pretty much guarante I’ll never see that money again, even when the hospital receives the funds from my insurance….Any advice for a very frustrated and stressed out gal?
I so so so appreciate anyone that can shed any insight. Also, thank you in advance. I may not be able to respond to comments in a timely manner, but I do appreciate them!