Hard to plan for medical expenses

I had a medical procedure earlier this year. The invoices and explanations of benefits (from the insurer) have arrived in my mailbox at an irregular pace. I assumed I was in the all clear when I paid the balance on one bill totaling $767.78.

But then I arrived home this evening. I saw two envelopes from my insurer. I owe a doctor $29.95 (related to the medical procedure). When I opened the other envelope, I almost had a heart attack. I owe the provider $1,913.29. What!!  That amount would virtually wipe out my mini emergency fund.

I called my mother and whined. During our conversation I noticed the submitted charges total $23,085.00 appeared similar to another explanation of benefits.

I later called my sister and whined. She told me, maybe it is an instance of double billing. When I compared the submitted charges of both explanations of benefits , I confirmed the amounts are identical. What a relief. I thanked my sister.

After getting off the phone, I began comparing the two explanations of benefits. And then I realized something. One itemized bill was not processed by my insurer the first time the provider submitted the bill.  Apparently the provider didn’t submit sufficient information the first time.  When the provider resubmitted the additional information which the insurer found satisfactory, my insurer paid its portion under the plan. There is a balance which I am responsible to pay.

To make a long story short, this is not a case of double billing. This is a situation where the insurer delayed processing the largest itemized bill because the provider failed to submit sufficient information.

So I am happy to say I don’t owe $1,913.29. Instead I am on the hook for $1,145.51. Still a hefty check I must write.  My mini emergency fund will take a hard hit. I will have to find extra money (from where?) to rebuild this fund.

It is so hard to plan for medical expenses. 😦

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1 Comment

  1. August 21, 2012 at 9:43 pm

    Reblogged this on The Money Heifer.


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