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Thirteen week billing update

5 Jul

I’ve seen a little bit of action on the billing front this week.

  • When I posted my last update, I had just emailed my second insurance information to Berkeley Emergency Medical Group and Bay Imaging Consultants. The next morning, I received an email from Bay Imaging Consultants informing me that they had billed the second insurance. I have still heard nothing from Berkeley Emergency Medical Group.
  • I received a bill from Alta Bates Summit Medical Center for my treatment. The total amount was $1,944.10, but insurance adjustments decreased that by $505.45 and insurance payments knocked off an additional $1,413.65, leaving me to pay only $25. I plan on paying ┬áthis amount by credit card in a few weeks so that it will go on my August statement rather than July. I have the money in my account, but I might as well earn interest on it for another month.I also requested an itemized bill from Alta Bates by phone, and this arrived on Friday. I haven’t found it very helpful, though. It does have a charge of $16.72 for “ORAL/IBUPROFEN 600MG T”, which I’m not sure I received. It’s possible that it’s something they had me take some in the hospital (but sixteen dollars worth?), but I definitely didn’t take a bottle home with me. The doctor actually gave me a prescription for ibuprofen, but the pharmacist told me to just buy it over the counter. I don’t plan on looking into this because I don’t think it would affect the amount I pay after insurance.

    Incidentally, neither the original bill nor the itemized bill tells me which insurance paid, but I think it’s my father’s insurance because I did tell Alta Bates that his insurance was primary.

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Twelve week billing update

30 Jun

It was a quiet week on the billing front with only one piece of mail coming in. I certainly can’t complain. Anyway, I took care of some of my outstanding obligations, too. Here’s what’s new:

  • I received a bill from Berkeley Emergency Medical Group for services performed in the emergency room, in particular the following:
    • “ER INTERMEDIATE EXAM” – My best guess is that this is just the doctor looking at my injuries. The full charge was $349, there was an adjustment of -$229.76 (presumably this is the difference between the network rate and the full charge), and insurance (the UC Berkeley plan) paid $95.39, leaving me with $23.85.
    • “INTER REP UP TO 2.5CM” – I think this refers to the suturing of my chin. I don’t know what “REP” stands for, though. In any case, the full charge was $527, but the insurance adjustment took off $329.60 and insurance paid $157.92, leaving me with $39.48.
    • “SIMPLE REP UP TO 2.5” – I think this refers to the suturing of my lip. The charge was $303, the insurance adjustment took off $238.16, and insurance paid $51.87, leaving me with $12.97.
  • The bill read a balance of $76.30, which doesn’t seem too bad, but I just sent them an email with my other insurance information to see if they can get that plan to pay some of this balance.

  • I filled out the form from Meridian Resource Company about accident liability online. I also emailed Bay Imaging Consultants with my second insurance information. When I say that I did these things, I mean that I did them within the last half hour. The good thing about me doing these weekly updates on billing is that it gives me an artificial deadline to meet my responsibilities. I feel like I should make some progress from week to week so that I won’t seem irresponsible to any hypothetical readers.

Teeth cleaning

12 Jun

I just got back from my routine six-month cleaning at the dentist’s office. I only saw a hygienist; the dentist didn’t look at my mouth. To my relief, she didn’t find any cavities. She told me that one of my back teeth has a deep groove in it that will need to be brushed extra carefully, but she emphasized that this was the anatomy of the tooth rather than a cavity.

When my mouth was wired shut, I was unable to brush most surfaces of my teeth, so I find it quite remarkable that I don’t have any cavities. A large part of this, as the hygienist pointed out, is that I’m lucky to have hard enamel. What I don’t owe to luck, I owe to my WaterPik, which proved to be an absolutely indispensable tool for cleaning my teeth and the wires around them.

I also learned that the dentist’s office has already billed my second insurance for the rest of the charges on my account. I should be receiving a bill for whatever they don’t pay in a few weeks. The statement of benefits from the insurance company, however, will probably go to my parents’ address.

Bills and such

10 Jun

I’ve been out of town for a bit, and I returned home this morning to find some billing-related materials waiting for me.

The only actual bill came from Bay Imaging Consultants Medical Group. as far as I can tell, this has something to do with the x-rays I received in the hospital. This is apparently separate from the radiology item on my statement from the hospital. The bill lists charges for three items: “ORTHOPANTOGRAM”, “SHOULDER COMPLETE”, “FACIAL BONES, COMPL., MINIMUM”. The total charges were $147, but payments from my insurance brought it down to $53.79. The bill doesn’t say, but I’m pretty sure (based on my memory of some paper which I think I have in a big stack somewhere) that those payments come from my UC Berkeley SHIP plan, rather than my parents’ plan (which is supposed to be my primary insurance). I’ll have to give them a call to see if I can get them to bill the other insurer for the remainder.

I also received an explanation of benefits from the university insurance plan for my services from the oral surgeon. The insurance was billed for $3,720, of which $3,200 was for the surgery and $520 was for anesthesia. The insurance company has covered $1,831.82, and they expect me to pay $1,888.18. Of this amount that I’m responsible for, $146.21 is applied to my deductible, $457.95 is my coinsurance responsibility, and $1,284.02 “exceeds the allowed expense and is the member’s responsibility to pay.” For the record, I don’t really understand what all of these words mean, but maybe some day I’ll find out.

I’m hoping that the oral surgeon’s office will bill the remaining balance to my other insurance. I shouldn’t need to remind them about my second insurance, seeing as they called me for information about it while I was still sleeping off the anesthesia from the surgery.

The last related document I received was an explanation of dental benefits from MetLife, which provides my dental benefits for the SHIP plan. This was for the repairs of the chipped teeth. The statement tells me that the fee for my services is ordinarily $372, but the dentist agreed to accept only $286 as part of his participation in Metlife’s Preferred Dentist Program. Metlife reports having paid $208.80, leaving me to pay $77.20. As I understand it, they are applying $25 to my deductible and then paying 80% of what’s left. I’ll have to ask the dentist if they are also billing my parents’ dental insurance. Either that or I will just wait until I have a bill before I do anything.

A day late

28 May

Somebody from Alta Bates returned my call a few minutes ago. It didn’t seem like she had any record of billing Blue Shield of California, but she did take my correct insurance information. She seemed surprised that I didn’t have a group number for my primary insurance, but she took my father’s name, date of birth, and employer information instead. She also told that they had the wrong member number for my secondary insurance.

Now I’m back to waiting for more bills (and non-bills) to roll in.

Non-bill update

27 May

On Saturday, I mentioned that I’d have to call Alta Bates on Monday to give them my correct insurance information. Of course, I was forgetting that Monday was a holiday, so I ended up calling Tuesday morning instead. I left a message on a voicemail system, and I was supposed to hear back within one business day. I called a few minutes after 9AM, so they still will have a few minutes to meet that deadline after the phones open, but I’m not very optimistic.

If I don’t hear back, I think I’ll wait until I receive an actual bill before I take things further.

More non-bills

23 May

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.

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