Most people freely admit that medical services billing and insurance coverage is a tricky road to navigate. When Clay had an unexpected attack, he had to go to the emergency room for treatment. All of this was, as usual, paid in full by the insurance provider. Two months later when Clay returned to his doctor for a check-up and to get his prescription refilled, Clay was was surprised when he was informed that the Advair he was required to take for the rest of his life was now going to cost him one hundred dollars every two months.
When Clay called his insurance provider, he was told that Advair was no longer covered under his plan. He said that he had tried other steroid inhalers, but they were ineffective. They said that this was not their problem. This was the responsibility of physician and patient. Three months later, Clay also received a bill for the entire payment of his treatment and lab tests at the previous doctor’s visit. He called the doctor’s office and was informed that his primary care practitioner was also no longer covered under his insurance. When he called the insurance company to complain, their response was that doctors were shifted from time to time and it was up to the medical provider to make sure that you knew that the visit was not covered. When Clay called the billing office he was told, that because he was a continuing client, payment was not required immediately, but billed him instead.
Clay fought the insurance company for years to no avail.. In the meantime, his credit was ruined since his unpaid bill went to collections. The doctor also went unpaid for Clay’s visit, as well as the loss of a good patient. Extra phone time and paperwork was required by the billing company, not to mention the stress of dealing with a disgruntled patient. The only ones who didn’t lose were the ones who were never confused and that was the insurance company.
