Health Insurance: Is $7,000 Worth the Call?

Uh…..was that a stupid question or what??

I received an EOB from the insurance company last week stating we owed the entire balance and our insurance paid $0 (YES, that's a ZERO). Well, what do you think I did?? No, not what I wanted to do, but what I actually did…

Of course, I called them and in my nicest voice (and a smile on my face) asked them to help me understand the claim since I knew it should at least have been paid at 80% per our Plan Documentation. The insurance company informed me that the EOB was incorrect and that our actual amount due was around $70 which was more like it. At that time, I also requested a copy of that EOB for my records since they never sent it.

In this case, I actually knew this claim had already been paid because I called the hospital the week before checking on what claims were outstanding for this visit. When I received this EOB, I was floored. Or, the true feeling was like someone punched me in the stomach since the thought of paying $7,000 on TOP of what we had already paid out of pocket made me sick.

This situation just shows you how important it is to know your insurance plan inside-out. I knew that there was no way they could get out of paying their portion of this procedure regardless if it was $7,000 or $700. Per our plan documentation, the insurance had to pay the appropriate co-insurance amount!

It's just one more reason why you need to Understand Your Health Benefits and save your family moola. Or, in this case, $7,000!  My hubby soooo needs to give me a raise :-)

by Savings Lifestyle: Andrea on February 25, 2008

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