Tag Archives: billing

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.
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Eleven week billing update

22 Jun

I decided to consolidate billing-related posts into a weekly digest from now on. I’d like to be able to say that it’s because I’m too busy to write a new post every time a bill comes, but that would be a lie. The only reason I can offer is that I was tired of thinking of titles for posts about billing.

With that said, here’s what’s happened in the last week.

  • I received a statement from my oral surgeon. It was dated June 10, which was the day I had the arch bars removed. It was addressed to my father, but at my address, apparently a result of confusion over the fact that one of my insurance policies is through my father. The statement said that I had a balance of $1,963.18 which was “Due Now.” This number is apparently the $1,888.18 for the surgery left unpaid by the UC Berkeley insurance plus a $75 fee for the office consultation the day after the accident. I had expected my second insurance plan to pay something, so I was a little bit surprised to see the whole amount due now. The statement also stated that interest of 18% per year would be charged after 60 days and that my entire balance was 61-90 days old. This latter measurement apparently began from the date of service rather than the date of billing.I called the office of the oral surgeon to see if they had billed the second insurance company. I was told that they had, that I would receive another statement after the insurance had paid, and that no interest would be charged until then. The statement I received was apparently “just an updated statement,” which apparently means I can ignore the part about the balance being due now.
  • I also received a letter from Meridian Resource Company, LLC, on behalf of Anthem Blue Cross seeking to determine whether somebody else may be liable for some of the charges from the oral surgeon’s office. The only way I can imagine that this would be the case is if the road condition were such that the City of Oakland were liable, but I doubt that this is the case.
  • I still have a bill from Bay Imaging Consultants for $53.79. They seem to have not billed my father’s insurance, so I should get them to do so. I’ve been lazy about it, though, because the bill doesn’t have a due date.

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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