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adayatatime | My Obgyn nurse is a.....? |
Need advice!!!! OK. on July 11 I went in to talk to my obgyn because I wanted to get an iuc inserted. He told me I was a good candidate I was healthy and could defenatly get it if that was my choice of contraception. His nurse then let me know she would call my insurance company to make sure they would cover the process and the iuc that was to be inserted in about a week she said she would call me back to let me know the answer. Next day she calls and tells me the insurance did cover but I was to make a payment of 300 dollars on the day of the process. I agreed to it. With in a week I had it put in. NOw about a month later a get a claim from my insurace company that i have met my maximum benefits and that i owe my obgyn 890 dollars for the contraception procedure I received. NOW WHAT!!!! no fair. Thank YOU!! for reading please need advice on what to do now. |
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mbrcatz
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Well, you're kind of stuck. The deal was, the nurse would check if the procedure is a covered procedure - it is. She did her part. The insurance company CAN'T TELL HER when you reach your limit - you're supposed to have some idea about what that is. All they can do, is tell her, yes it's a covered procedure, or no it isn't.
It's pretty hard to appeal the decision, based on maximum benefits. But you sure can try if you want. I'd call the insurance company and ask. There's a big difference between finding out if a procedure is covered, and getting pre-approval for it. And ultimately, the responsibility for the pre-approval is yours. |
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devyl gyrl
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Call the doctor and speak with him, and with the nurse staff in his administrative office. There may be a way that they can work with you on this, so that you don't have to pay the additional monies. After all, you only had the procedure because his nurse told you that you would be covered.
Always check with the insurance company YOURSELF on these matters. Especially if you have a top-out amount on your insurance! |
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~*Jen Jen*~
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I'd probly go back to the OBGYN and speak to that same Nurse... I'd call my insurance company beforehand to make sure she called in the first place... then confront her about it... see where it goes from there. |
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Expert Realtor
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You need to call the billing department for your OB-GYN and straighten it out. I have actually never heard of a nurse being involved in billing...that is usually something the doctor will discuss with the front end staff.
There is a TON of legitimate reasons why this may have happened, so don't get mad yet. |
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Rick B
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Call your doctor and remind them that insurance was not going to cover it and that you were to pay them $300 as a cash customer. They will correct the bill and you will be all set.
No biggie. |
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Fran
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I have found in the past that it is always good to call the insurance company yourself and be sure to document date and time and also the name of the person you talked to. I don't ever count on anyone calling for me because you don't know unless you hear it yourself. It sounds like there was miscommunication. Talk with the person at the doctor's office that made the call. She should have documented her conservation with the insurance company. Hopefully you can work something out. By the way if you paid $300.00 is probably $300.00 if the $890.00 which by itself seem way too much for the IUD. If you do not get results from that person speak to the doctor. |
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