Every time I use my health insurance card, some one steals from me. \u00c2\u00a0This isn’t a figure of speech. \u00c2\u00a0This isn’t me exaggerating. \u00c2\u00a0This is the cold hard truth. \u00c2\u00a0This isn’t something that happens in Puerto Rico, or Florida, or Texas. \u00c2\u00a0It has happened everywhere I’ve used my Cigna card. \u00c2\u00a0And frankly, this isn’t even something specific to Cigna. \u00c2\u00a0When I had Blue Cross Blue Shield, it was the same thing.<\/p>\n
Follow me through how I used my insurance twice in the span of a week and a half, and got over charged a total of $1700, while EVERYONE from the tech, to the doctor, to the health insurance company took a bigger slice of the pie they were entitled to.<\/p>\n
First, some background. \u00c2\u00a0My insurance covers one free physical a year, so I usually partake in this luxury. \u00c2\u00a0And while I was out (I don’t get out much), I decided to check the repetitive strain injury I have acquired from years of typing. \u00c2\u00a0Yano hooked me up with an unnamed colleague of hers specializing in hands, so I decided to visit two doctors in one day.<\/p>\n
Since we are relatively healthy, we have a high-deductible health insurance plan with a health savings account (HSA). \u00c2\u00a0Which means that the first $6000 of the year are on us, and it comes out of our HSA account. \u00c2\u00a0This is the only reason I notice when we get overcharged, because I see the balance instantly diminish on mistakes.<\/p>\n
A few weeks after my visit I got an explanation of benefits from Cigna in which I saw a total of approximately $3000 that came out of my HSA. \u00c2\u00a0WTF?<\/p>\n
THE PRIMARY CARE PHYSICIAN<\/span><\/strong><\/p>\n The primary care physician ordered $400 worth of labs. \u00c2\u00a0I had to call him and ask for a complete break down so I could follow up with Cigna. \u00c2\u00a0The physician even charged $25 for walking the blood, literally, across the street to the lab. \u00c2\u00a0Of course, they chose the most expensive lab. \u00c2\u00a0Though, I can’t fault them, because considering the proximity to their office, I can understand the convenience.<\/p>\n As is usually the case, the primary care physician is at fault for very little of what actually gets charged, but is nevertheless responsible for some…<\/p>\n A few calls to Cigna revealed that because the labs were out-of-network, they had paid the entire amount (out of my savings account). \u00c2\u00a0I explained that I went to an in-network physician, and they proceeded to adjust the claim. \u00c2\u00a0Savings: $400. \u00c2\u00a0In reality, however, I could’ve gone to any number of labs across the city to get my CBC and lipid panel done for a tenth of the cost, saving my fellow Cignites copious amounts of health insurance premiums– but that’s a separate problem. \u00c2\u00a0In reality, the lab over charged, the plan over paid, and the physician didn’t have the common sense to send the lab to a more economical place. \u00c2\u00a0This is what’s called in economics, moral hazard: the cookie jar ain’t mine, so I don’t care who takes the cookies.<\/p>\n THE ORTHOPEDIC SURGEON<\/span><\/strong><\/p>\n Upon entry to the orthopedic surgeon’s office, my HSA credit card got swiped, as a “precautionary” measure, just in case my health insurance didn’t cover enough. \u00c2\u00a0The secretary then informed me I needed to have an in-house X-ray. \u00c2\u00a0I politely explained that I had no broken bones, and that I was coming for a repetitive injury I had had for a decade. \u00c2\u00a0The secretary insisted. \u00c2\u00a0I explained a possible neuropathy of the ulnar nerve, to which I got a glazed look, and a repeat of the obvious– “you need an xray; it’s standard procedure”. \u00c2\u00a0I stood my ground and told her “if after I see the doctor, he would like me to get an x-ray, I will do so”. \u00c2\u00a0That was the end of THAT<\/em> over-billing, or so I thought…<\/p>\n Weeks later, the ortho’s office calls me and informs me that they are reversing a $300 charge, for something they over billed. \u00c2\u00a0Whuuut? \u00c2\u00a0I was told that they over billed “just in case” my insurance wouldn’t cover everything, and that they were reimbursing me $300. \u00c2\u00a0I got suspicious and went back to my HSA statement, where I found that not only was I over charged $300, but I was billed twice for $97, and some neurologist I had never met charged me $1970.<\/p>\n Being the cool cat that I am, I decided to ignore the $397 I was over-charged, and concentrate on the $2000 on my bill. \u00c2\u00a0To my surprise, the ortho’s office had no idea who this neurologist was. \u00c2\u00a0After some detective work I realized it was the neurologist that read the nerve conductivity test (EMG) at the ortho’s office. \u00c2\u00a0Ironically, the ortho’s office disassociated themselves from the neurologist and claimed they didn’t know who he was, and were in no way associated with him– that they only rented out the space to his staff. \u00c2\u00a0Fair enough, I would call him directly…<\/p>\n THE NEUROLOGIST<\/span><\/strong><\/p>\n I had a nerve conductivity test done by a lab tech, with 20 year old equipment. \u00c2\u00a0The procedure required $5 worth of needles, lasted 15 minutes, and the neurologist who never saw me, charged $1970. \u00c2\u00a0Fair enough, I work from home. \u00c2\u00a0I applaud working in your underwear. \u00c2\u00a0What didn’t make sense was the $1970.<\/p>\n The explanation of benefits from Cigna showed 4 labs and 3 supplies. \u00c2\u00a0Since I called another neurologist friend of mine, I knew the needles didn’t cost more than $5, so I couldn’t wrap my mathematical mind around $100 worth of “supplies”. \u00c2\u00a0Cigna couldn’t tell me what the individual charges where because of “privacy” concerns. \u00c2\u00a0They said I must call the doctor’s office directly and ask them. \u00c2\u00a0 Hmmm… so here I am, getting charged $1970, and the entity (Cigna) who took the money from my account can’t even tell me what it’s for. \u00c2\u00a0So…<\/p>\n After much googling, I find a suitable phone number, and call the neurologist. \u00c2\u00a0I explain my predicament, but they have no record of me. \u00c2\u00a0I am told I will be called by the billing department, but after a week, I receive no calls. \u00c2\u00a0I call them multiple times, and eventually break down and tell them I will call my insurance company, say the charges are fraudulent, and reverse the charges. \u00c2\u00a0I get a call back within 5 minutes.<\/p>\n They had no record of me. \u00c2\u00a0No one could explain why they had charged what they charged. \u00c2\u00a0At one point they wanted me to send them my explanation of benefits, to which I politely declined. \u00c2\u00a0If they didn’t know what they charged me for, I sure as hell was not going to make it easy for them to make shit up.<\/p>\n Eventually I got a call back from the outsourced company who did their billing, who found that the doctor had indeed received a payment for $1970, but due to some “unexplained” reason, the payment had bypassed the office altogether. \u00c2\u00a0The billing company told me not to worry because my insurance had paid everything. \u00c2\u00a0I explained the way high-deductible plans with HSA’s worked and how it had all come out of my savings account. \u00c2\u00a0Silence on the other side… All of a sudden, the caller turned apologetic and said $1970 was way too much, and that they would resolve this with the doctor’s office. \u00c2\u00a0So wait, $1970 is way too much if a human has to pay for it, but if a health insurance plan pays for it, then it’s ok?<\/p>\n Eventually I got on a conference call with the billing company and the doctor’s office, who at one point asked me if I had had a sleep study done. \u00c2\u00a0At no point would they tell me what they had actually billed me for…<\/p>\n To make the long story short, they are in the process of reimbursing me well over half of what they charged.<\/p>\n Conclusions…<\/span><\/strong><\/p>\n Total saved by numerous phone calls $1,700.<\/p>\n The frustrating thing is that I had to hunt down billing departments, medical plans, doctor’s offices, and at one point I had to physically get the copy of the doctor’s order requesting the EMG. \u00c2\u00a0This by no means is within the realm of say, my grandmother, when she visits the doctor. \u00c2\u00a0And this all happened within a week. \u00c2\u00a0And this happens every fucking time I use my health insurance card.<\/p>\n This wasn’t at all weighted on the neurologist’s side. \u00c2\u00a0Everyone involved tried to take a bigger slice of the pie. \u00c2\u00a0Fortunately for the neurologist, he had a broader variety of procedures he could charge for. \u00c2\u00a0But every single entity involved from day one bit as much as they could take in, in one mouthful.<\/p>\n The MD’s shall remain unnamed, because I think it would be unfair for me to single any of \u00c2\u00a0them out, when EVERYONE<\/span> is doing this shit. \u00c2\u00a0The entire system is broken, and has evolved into an over billing fiasco. \u00c2\u00a0The labs are over paid (when they get paid). \u00c2\u00a0The doctors are over paid (when they get paid). \u00c2\u00a0The hospitals are over paid (when they get paid). \u00c2\u00a0When the cookie jar is open, every one will grab some cookies. \u00c2\u00a0Unfortunately, there is enough overhead, and enough groups of people (rich and poor) not paying, that it offsets this over payment for the providers involved. \u00c2\u00a0But this doesn’t make it right… it’s wrong, and it’s broken.<\/p>\n And if you think it doesn’t affect you because you have a low deductible– surprise, everyone else on your plan is picking up your slack. \u00c2\u00a0We all pay for it– either in higher insurance premiums, or in higher taxes (medicaid\/medicare), or any combination of the above.<\/p>\n It is such a big pity that the last four years were spent with Republicans bitching about Obamacare, instead of offering an actual counter proposal that would actually work.<\/p>\n Oh that both sides could work together for the common good. \u00c2\u00a0But as long as everyone that is reaching into the cookie jar is lobbying in congress, there will be no respite.<\/p>\n","protected":false},"excerpt":{"rendered":" Every time I use my health insurance card, some one steals from me. \u00c2\u00a0This isn’t a figure of speech. \u00c2\u00a0This isn’t me exaggerating. \u00c2\u00a0This is the cold hard truth. \u00c2\u00a0This isn’t something that happens in Puerto Rico, or Florida, or Texas. \u00c2\u00a0It has happened everywhere I’ve used my Cigna card. \u00c2\u00a0And frankly, this isn’t even … Continue reading Yes, your doctor is stealing from you (but so is everyone else).<\/span>