It's officially been over a year since I have been trying to get Blue Shield to pay their bills for services rendered in February 2010. So continuing the Blue Shield "refund" situation... There are three health care providers involved in the refund: the hospital, the specialist I was seeing, and a pathology lab. The hospital had already sent their claim to UHC and been denied, meaning all they had left to do was bill Blue Shield. I received a call from the specialist's billing office immediately following the Blue Shield refund-demanding letter, and I had to explain to them what to do because they can't read, apparently. I told them to bill UHC, then send the explanation of "benefits" to Blue Shield with a claim. They said they would...I'm sure that's exactly what is going to happen.Two months later....no word from the hospital. The pathology lab had billed United Healthcare twice for some reason and been denied twice (since United Healthcare didn't provide coverage for what I had done, which is why Blue Shield was supposed to pay for it). No claims from specialist had been sent to United Healthcare as the letter had dictated. However, I received a BILL from the pathology lab in the amount of $800, saying they had not received a response from Blue Shield. Note: Blue Shield did not deny their claim, they simply hadn't "heard from them" so they decided to bill me rather than check with Blue Shield to see if they had received the claim at all. I checked, because apparently it is my job, and Blue Shield had no record of the pathology lab's claim. I called them up and was actually surprised at the seeming understanding with which I was met on the other end of the phone line. Anyway, they said they would re-bill Blue Shield with the UHC explanation of benefits. I have yet to see any evidence that this has happened, but for now I don't have to worry about the bill...
Yesterday, I received a letter from the specialist's billing office, saying it was their third and final notice, and that I needed to pay them $350 or have collector's sent after me and a black star of death put in my credit report. Might I mention that I never received a first, or even second notice? Oh boy. I think my blood pressure skyrocketed several points and I instantly felt nauseous. They called me months before, assuring me that they would follow the directions that Blue Shield had sent them (in October 2010, mind you, for services rendered in February 2010!!!!). Lies. They had not sent any claims to UHC, nor had they re-billed Blue Shield, nor had they sent me any bills. Now they were threatening to send bill collectors after me. I passed the task off to my husband, because I might have a stroke if I have to call one more billing office and read directions verbatim to them off of a piece of paper that they already received themselves in an effort to get them to do their job. These are billing offices, mind you, that spend all day doing nothing other than BILLING HEALTH INSURANCE COMPANIES. GOOD GOD PEOPLE!!!!
To sum up:
Hospital - MIA. I have heard nothing from them. No claim to Blue Shield, and they have never sent me a bill. I paid them a $250 deductible, and from what I have surmised I think they actually owe me $7, which might be why they aren't billing me.
Specialist - Sending me threatening 3rd notices, without attempts 1 or 2. Have yet to send a single claim to either of my health insurance companies, but seem to have no trouble billing me.
Pathology Lab - Supposedly are in the act of billing Blue Shield with the explanation of benefits from UHC (as they're supposed to do). If Blue Shield receives the claim, all should be well here...
Needless to say, the story is not over until Blue Shield pays their bills (which is hard for them to do when nobody bills them...). So I'm sure there will be another entry soon to come. Stay tuned!
