Insurance Issues

I spent about an hour today trying to resolve a claim from my husband's visit to the eye doctor in October 2007. He went to a new doctor because the doctor we've used since the mid-90s could not find the cause of his headaches and vision issues. Because he was unsure of our insurance coverage, my husband paid the full fee of $199, and we filed the claim ourselves. The new doctor coded the visit as an annual exam instead of a problem-focused (ah, the irony) exam, and the insurance company denied the claim because my husband had already had his annual exam in 2007. Now I have a problem to focus on!

After talking to the insurance company, I called the billing manager to ask him to change the codes so that we can resubmit the claim. The billing manager told me he would speak with the doctor and call me back. Five hours later--still no call back. On Monday, I will call again because I would like to get back at least some of our money.

In addition, the eye doctor referred my husband to a specialist for another $75. On my husband's second visit there, we were overcharged by $9--it was on the bill, and my husband overlooked it. Then after the insurance company processed the claim, our part of the bill was reduced. Balance due to us--$27. I will also call this office on Monday, unless a check arrives tomorrow.

Have a great weekend!