I have learned the hard way to never, never self-pay when you have insurance. Last April, my husband started a new job and got new insurance, but it took a few weeks for us to be entered into the system and receive our insurance cards. So for a few weeks, I could not prove that I had insurance to doctors' offices that needed to know. And I happened to have a very expensive appointment to keep with a neurologist to do nerve testing. When I say very expensive, I mean it: $4,000. And of course, the doctors' office insisted that I pay up front for everything because they could not verify that I had insurance.
I should never have blithely put that $4,000 on my credit card! Almost 14 months later, they still haven't given all of my money back to me. I did eventually get an insurance card that proved that I was covered by health insurance the day of the tests. And the doctor's office did eventually bill the insurance for the charges related to that appointment. But it has been like pulling teeth to get them to give me my original $4,000 deposit back. First, the doctors (this was a hospital visit, so there were people from multiple departments involved) had to bill the charges to my account. Which took up to 6 months! Crazy. Then the billing office had to ask my insurance to cover the billed charges. Which took many more months. Then the billing department had to process the payment from my insurance and post it to my account. Then they had to release my original payment in bits and pieces as "credits" to my account. Which I then had to call and specifically ask to get paid back to me! And because of some billing/accounting issue, they have to process repayments to me as checks... which takes several more weeks.
Almost 9 months into this game, I had recuperated about $3,000 of the $4,000. But there was $900 or so that seemed to have disappeared altogether. After driving the billing coordinator crazy with calls about it, she mailed me a 50-page ledger of billing activity for my account. After weeks of staring at it, I figured out that $900 of charges were never sent to insurance... so I would have no chance of getting that money back until they did so. After convincing the doctor's office that they needed to bill those charges to insurance (they thought they had, and that my insurance had denied the claim altogether, but I had no explanation of benefits showing that, so I knew they were incorrect), I've been waiting a few more months. And finally, last week, they agreed to send me my last $800. I say $800, because along the way, about $100 has disappeared. And I'm too worn out to go find it!
Of course, I'm still waiting to actually receive the money back. Wish me luck!
What can you do if you find yourself needing medical care at a time when you have insurance, but can't prove it (because you don't have a card yet and aren't listed in the health insurance company's system)? Just DON'T do it. Don't pay for the appointment. Wait if you can. I could have waited a few more weeks for my neuro testing. And should have. Or you can work out some kind of payment plan with the doctor - pay 20% up front and 20% for each month thereafter. (In the amount of time you will need to pay off the bill, you will get the insurance card in the mail and can have the doctor bill your insurance instead. So you will be fighting with them to get your original 20% back, but probably nothing more than that.)
And please do go to the ER for emergency care if you need it. Your life is that important! And ERs won't ask you to pay up front if you're in dire need of care.
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