The Sneaky World of Medical Billing

Ok so I went to see my ENT back in October for allergy related problems and an ongoing sore throat. The date of service was 10/03/08. I get a bill in the mail dated 12/19/08 in the amount of $15 for this date of service. I find this bill quite peculiar, since $15 is my co-pay amount, and I KNOW I paid my co-pay when I was there. Usually I wind up losing receipts like this one, but I actually managed to find the receipt from that co-pay. I thought surely it was just an error on their part, perhaps because I was changing my name on that date and they may have filed it under someone else's name by mistake?

I call this morning and am told that when the insurance paid my claim the amount I was responsible for waws $30. So I still owed $15. I tried to find out what exactly the $30 was for, but the account rep couldn't tell me. She said she didn't have that kind of information. When there is a balance above and beyond a co-pay for a doctor's visit I usually get a statement from my insurance company in the mail, so that the doctor's bill doesn't come as a surprise. Since I never received such a statement, I decided to call my insurance company (wanted to make sure that my benefits hadn't changed or something).

When I called I found that there were TWO claims for 10/03/08. Strangely enough they were BOTH for the exact same dollar amount.
B I N G O! The ENT had billed my insurance twice for the same visit, and the insurance company didn't catch it. So they paid each claim individually, and of course for EACH claim, I have my co-pay responsibility. So you double that, and sure enough the balance on my end would be ANOTHER co-pay amount. I immediately figured this out and informed a rep who is going to go back and cancel the second claim as a duplicate.

At this point I figured it only right to go back and call the doctor's billing office to let them know what I had found out. The woman I spoke to said she would look into my account and call me back. (HUH! like I need to be called back about this, noooooo!) I am sure that the ENT billing and my health insurance will get it figured out. My sleuthing saved me $15. Too bad for the ENT office, it cost them quite a bit more. If they would've just taken their money and not sent me a bill for $15, nobody would have been the wiser. Too bad for them.

Just goes to show you that just because you receive a bill in the mail, doesn't mean it's right. Fight for what you think is yours! This time it was only $15, but what if next time it's $150, or worse, $1500. I've learned to check everything twice (just like Santa).