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Linda
Brandwin, R.N.
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Linda
Brandwin
is a registered nurse and a medical billing
and claims specialist. For the past 10 years
she has worked directly with insurance companies
to give advice and guidance to the health care
consumer.
Readers may send email
or write Linda Brandwin at 5500 Single Oak Hill
Ct., Woodbridge, VA 22192.
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Get
more information when questioning a bill
Sept 24, 2004
Q:
I
recently received two bills. One was from a hospital
and one from my oncologist. These bills were for services
performed two and half years ago. These were the first
bills I have received for these services. I did get
a statement three months ago from my oncologist's office
which said I owed for a co-pay and they are still waiting
for the insurance company to pay. I copied my check
for the co-pay so this should not be a problem. But
I was shocked by the bill I just received from that
office for $104.40.
One
year ago I cleaned out the many insurance statements
and billing invoices I accumulated because I thought
everything had been paid.
Since
receiving these two bills from services rendered over
two years ago, I have tried to contact our insurance
carrier at that time. We no longer have insurance with
this company. I have not been able to reach them or
find any information about them.
I
have found several old insurance EOBs which indicate
that my major medical deductible and my out-of-pocket
deductible have been met. The billing offices don't
seem to be able to give me any assistance other than
the original telephone number that was listed on my
insurance ID card. I have called this number with no
success.
Can
you give me some advice? I now have more than $500 worth
of bills. If I have met my out-of-pocket, I really don't
want to pay again.
A:
First
I would find out why there was a two year delay in billing
from the oncologist's office and the hospital. This
does not make much sense. Have they really been trying
for two years to receive reimbursement from your insurance
company? What made them stop trying? Have they received
any EOBs from your insurance company? If they have EOBs,
ask for copies. The health care provider's EOB may reveal
a lot of information for you. It may have an address
and phone number, it may state if the insurance company
paid and how much and when, and it may even indicate
what is your financial responsibility.
It
sounds like your insurance carrier may have paid something
on your bills. Perhaps what you are being billed for
now is your share of the deductible. Your old EOB states
that your deductible has been met, but it will not indicate
if you have actually paid your portion of the deductible.
Your insurance company calculates their share of the
health care provider's fees after they factor in your
deductible. The insurance company has no way of knowing
if you have been billed for the deductible portion of
the bill or if you paid that bill. And I have no way
of knowing if this is the reason you are being billed
or not. You need more information. The doctor's office
and the hospital need to tell you about any payments
they have received.
If
there is no EOB, if the oncologist's office and hospital
have no information for you and if you can not locate
this insurance company, call your state insurance board.
You can also contact your state's attorney general's
office.
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