Little charges count, too. READ YOUR insurance company’s EXPLANATION OF BENEFITS details on your bills!

Today I personally “saved” myself a $35 charge.  Unfortunately, the “billing error that is sometimes generated” was a mistake that would not have been caught without calling the (largest) HMO and questioning, and staying on hold 4 minutes while “Kelsey” talked with billing to correct the error and remove it from my account.

Details:  At time of annual eye exam, I made my regular office visit copay.  The exam went as usual, with a clean bill of health and a new prescription for “reading glasses”  but a month later I got an additional copay for the same amount previously paid.  Inspecting the bill revealed this detail:   Procedure 92012, “eye exam” was credited what I had paid with nothing more owed. However, additional Procedure 92015 LENS EYEWEAR PRESCRIPTION ASSESSMENT” included a new charge for $35.

Guess what?  My doctor had no clue..her manager had no clue…and even after 40 years of servicing health insurance, I had no clue why there would be a charge for writing a prescription.   The HMO’s claims department representative, Kelsey, had no idea either but kept saying that extra billing was “sometimes generated”.  She would not say how many times people had called in; nor whether they would find and remove the mistake if someone did not call in..only that in my case, she would take it away as it was an error.

Moral of the story is two-fold.  The first moral is in the title.  READ your statements and REVIEW for errors.  Don’t pick up the phone and complain to the doctor, broker, or State insurance commissioner…unless you do not get satisfaction after picking up the phone and complaining to the actual insurance billing office.     The second moral is just a suggestion…publicize.  I’ve put the billing error out on my, social media accounts, and just wrote this blog for the business.  If everyone shines the bright light of publicity, maybe the insurer will figure out how or why “the system sometimes generates” a billing when it should not do so.  Hint:  someone told it to do this duplicitous billing, and someone is taking credit for a better-than-expected bottom line.  Fight it!   And don’t forget to get your eyes checked annually!