Ahhh, insurance. Health insurance is its own special circle of e-he!!. I work for a integrated regional HMO who has begun to sell deductible benefit coverage to patients who previously only paid a co-pay, or fixed fee, for services. Under the deductible coverage, they pay full price for what ever medical services they receive until their deductible is met. This has led to some mighty interrrresssting conversations:
"What do you mean I'm on a deductible plan!!! No one told me!" Um, did you read the packet of information that came with your insurance card? Attend your employer's open enrollment meeting where they explained the plan change? Maybe you should have.
"I just want to know the exact
cost for XYZ procedure." Whereas that seems like a reasonable request, but I can only give you an estimate as I have to wait for the provider to perform the procedure, record precisely
what he or she did to you, based on your overall health, pre-existing conditions and your specific health conditions, then have our systems process your claim to find out, to.the.penny, exactly how much your service will cost. Healthcare is not retail pricing.
"If I went to hospital/provider-down-the-street, they wouldn't charge me for services, they'd bill me." You might want to go to that office and notice that sign prominently displayed in their lobby, like just about every other health provider's lobby that reads, "We expect payment at time of service" or some variation thereupon. Doctors expect payment at time of service these days and did you also know they no longer do house calls? (end sarcasm)
"The provider ordered/performed services that I didn't know would cost extra. I refuse to pay for them." Um, you got them, you pay for them. It's up to you and your provider to make medically necessary decisions, regardless of cost.
"I asked the desk clerk/janitor/random person behind the desk what this would cost and they said wrong-cost." Thank you for letting me know so I can contact their supervisor and have the employee counseled to not give erroneous information to our patients. I'm sure that employee will never be that helpful to you or any other patient again now that you've gotten them in hot water.
Give me a minute, maybe some more will come to me.