Today I got a bill for $739.00 from an ambulance company. Yay! What fun! Always love an unexpected bill. What really amused me was the fact that it listed out the expenses:
Ambulance services: $739
Insurance adjustment: -$194.09
Insurance payment: $544.91
Insurance take back: -$544.91
Adjustment: $194.09
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Please pay this amount: $739
Wait... So the insurance company paid this bill and then took it back?!?!? How is that OK?
Apparently, this happens ALL THE TIME. Insurance companies aren't very good at keeping up-to-date information.
I used to be on a COBRA plan through BlueCross/BlueShield (CareFirst--a DC-based franchise). According to BCBS policy, if the care is provided out of network, the provider has to bill the local BCBS. So, they billed Michigan BCBS.
Then, I switched to my partner's plan -- also BCBS, and a local Michigan plan. At the time of the service, I was on my partner's plan. So, how is it that a claim submitted to the local BCBS (albeit under the incorrect member number), wasn't checked for active and valid coverage?
Wait, isn't there something called "Coordination of Benefits?" From the name of that, it sounds like insurance companies will coordinate with one another to make sure you are covered. This would be especially easy if ALL of the coverage is within the same company.
Yeahhhhhh... they don't really mean that. It's like when a law is passed with a name that implies the opposite of what it actually does (read: No Child Left Behind). Coordination of Benefits would be better named "Makin' damn sure we don't pay fo' shit we don't have to."
One would think that BCBS could figure out that I'm covered under another plan with them.
IT GETS WORSE: I received a letter from the "Corporate Recovery Unit" telling me to repay them for $139 for services they covered after my coverage ended. This was a case where I went from my partner's plan to my own in the same damn plan. The best part is that they wrote: "If you have other coverage for the attached date(s) of service, please contact the provider/pharmacy where you received the service and ask them to bill the correct insurer and reimburse BCN." So... I should have them bill BCN to reimburse BCN for services paid for by BCN.
Awesome.
