I opened the mailbox today to find an envelope from Blue Shield of California. I figured that this had to do with my medical bills, but I was surprised to receive mail from Blue Shield of California because neither of my insurance policies were through that entity.
Opening the envelope, I found three sheets of paper with two explanations of benefits. Each was for a claim for services rendered on 04/05/09, the date of my accident. Both claims were received by the insurer on 04/24/09 and processed in 3 days, and the documents claimed to have been issued on 4/28/09. Each carried a “Subscriber ID” number that somewhat resembled the one on my card for the UC Berkeley Student Health Insurance Plan.
One statement was for services from Alta Bates Summit Medical Center, the hospital where I received emergency care. It listed 10 items, all classified as “MISC SERVICES”, for a total cost of $1,944.10. The second statement was for services from the Berkeley Emergency Medical Group, and carried 3 “MISC SERVICES” items totalling $1,179.00. This was the first I had heard of this entity or any of its charges. Both statements explained that Blue Shield hadn’t paid any of the costs, justifying this with a note:
Our eligibility records indicate that htis person is not currently enrolled in a Blue Shield plan. Please contact the Blue Shield Customer Service Department if you have additional information regarding eligibility.
In other words, Blue Shield sent isn’t paying for my medical services because I don’t have insurance with them. It would have been nice if they had, obviously, but I can’t say I expected any better.
Of course, this raises the question of why a claim was submitted to Blue Shield of California in the first place. It’s possible that the hospital confused Blue Shield with Anthem Blue Cross, which administers Berkeley’s SHIP plan. However, I already received on Wednesday (but was too lazy to blog about) an Explanation of Benefits from the SHIP plan for some small charges for Radiology services from Bay Imaging Consultants administered on 04/05/09, so it seems that somebody in the hospital must have gotten their hands on my correct SHIP insurance information that day. The other possibility is that they billed Blue Shield of California instead of Blue Cross and Blue Shield of Massachusetts but used the my SHIP member number.
I’ll have to call the hospital’s billing line on Monday to get things straightened out. I may have to call the Berkeley Emergency Medical Group, also. I’ll try to get itemized bills, as well. I really don’t understand, though, why everything is getting billed incorrectly. All of my providers have seen my insurance cards, so it just shouldn’t be that hard.
Shock and Jaw 