Yup, that's right.
Completely smell-o-licious.
I discovered last night (when I got an EOB saying I owed a doctor $196) that once again the folks who administer our health insurance have messed up our deductibles. They did this the year Miss Bee was born and I just got that mess straightened out.
See in SC spouses who are both state employees must carry their own insurance and can't be covered under their spouse's state coverage. They do however allow you to link your accounts for deductible and coinsurance purposes. Nice, huh.
For some weird reason I am linked to The Cop (who has the girls on his insurance), but The Cop is not linked to me. So when Sweet Pea, Miss Bee and I were all sick in January and February the claims that went toward my deductible combined with theirs and we met our family deductible.
Or so I thought.
Then I went to the doctor twice in April and now it's saying I owe $45 to one doc and $196 to another. Um, look again please, something isn't adding up!
I spent 45 minutes on the phone with a claims and membership specialist. Since I work for the agency that designs the benefits for the state employees, I totally used my super secret list of direct phone numbers, I bypassed regular customer service. She's checking it out and she's going to let me know when it's fixed.
In the meantime I have to fend off the billing offices who aren't going to be happy with me telling them I don't owe them any money.
I LOVE health insurance...not.
Super Summer
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2 comments:
Wha?
TPA? EOB?
Are you speaking English???
Maybe this is why my checking account is so low.
"Ma'am, you owe us three hundred and ninety bazillion dollars and thirty-two cents, please."
"Um. Okay. Um. Do you take checks?"
Who'da thought you could tell them you don't owe them money?!?
Sorry! Translations....
TPA ~ Third Party Administrator...in my case, BlueCross BlueShield of SC.
EOB ~ Explaination of Benefits...the piece of paper the insurance company mails you to tell you what they paid on your claim.
I guess you can only really tell them you don't owe money when you don't owe money, LOL.
You can tell them you will only pay your co-pay and co-insurance and to please file your insurance and bill you if there is a balance. Most practices will do that much for you.
Honestly, I wonder how many other people get messed up, pay too much, and they never realize it? It's my job to find errors like this so I always use our accounts as a "test" account. I'm always finding crazy stuff.
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