Follow Up

If you'll recall, I had to use an ambulance service on March 7. Well, I got the bill for it ($1097.75), was shocked, and then spent time figuring out the procedures for submitting it to my insurance and getting them to pay for it. I actually spoke with a rep to answer some of my questions before sending it to them. I included the original bill at her suggestion so that "(they'll) take it from there!"

I received a letter from my insurance company today saying they couldn't process the claim because I didn't provide a procedure code. Well, no shit. I included the bill, so they had all the information I had. A brief look would indicate that it didn't include the procedure code, so I didn't include it.

So I called them and asked how I am to get that information, as they had the original bill. I had been an idiot and not made a copy of the bill, so I was without the info. Not sure what brain fart caused that, as I normally am pretty good about that sort of thing. The rep I spoke with this time seemed put out that I made her go look up the original bill, provide me with the phone number, and identifying number, so that I could then call the ambulance company and ask for the procedure code.

Then I phoned the ambulance and spoke with Lori in billing. I told her my problem and asked for the procedure code. She wouldn't provide it. Instead she said, "If you had just sent the bill in with your insurance information, we would have billed them directly." I replied that the bill I received had no statement to that effect and no place to put that information. I was so surprised by that, that I showed it to Renee at work and she can verify that fact! However, Lori assured me that it did, in fact say that and have an entire entry area on the back for that information. I, again, assured her that I have a witness that it did not.

She took my insurance information by phone and will bill the insurance company directly.

This is all troubling because it could have been avoided in a number of ways.

• The bill could have and should have had the insurance portion like Lori said it did. All I can figure is that I received a second notice instead of a first and the second notice does not include that information.
• The insurance company could have simply called, identified themselves and the patient for whom they are calling, and asked for the needed proc. code. This would have saved time, money, and a lot of people's efforts.
• The ambulance people could have taken my insurance information one of the three or four times I offered it and billed insurance first thing.
• The original representative to whom I asked questions could have provided me with better, more detailed information. Or suggest I contact the ambulance company directly and see what their billing dept could do for me.
  

There are many reasons why insurance rates are astronomical and why people hate dealing with HMOs, PPOs, but the sure volume of bureaucracy one must deal with to get even the most simple claim paid is ridiculous.