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In Network or Out of Network?

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ShellShock

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So I checked my insurance company website and confirmed that my surgeon and the hospital I am going through are both in-network. When I called they explained that according to the paperwork that they received it was listed as my going to the Center for Weight Loss Surgery and that it was out of network. I talked to Kay the billing person at the surgeon’s office and she said they pulled this information from an old record and didn’t bother to change the information to St. Francis Hospital which was written on the form. So they are supposed to change it and send me another letter in the mail. She also straightened out the authorization dates to the correct surgery date.

Kay thanked me for keeping such a good eye on my paperwork. I have to say that everyone needs to read the invoices and all letters when it comes to insurance or bills from the doctor. I always pay attention to what I get because there are always mistakes. I have had to call and fix things more than once and the end result meant I didn’t have to pay the amount that I was billed for. Kay has so many people to do this for that I am sure she can’t catch all the mistakes.

The out of network percentage that I would have to pay would have been 30% and the out of pocket year maximum is $2000. So I would have had to pay a lot more considering I have already met the in network out of pocket maximum of $500.

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So I checked my insurance company website and confirmed that my surgeon and the hospital I am going through are both in-network. When I called they explained that according to the paperwork that they received it was listed as my going to the Center for Weight Loss Surgery and that it was out of network. I talked to Kay the billing person at the surgeon’s office and she said they pulled this information from an old record and didn’t bother to change the information to St. Francis Hospital which was written on the form. So they are supposed to change it and send me another letter in the mail. She also straightened out the authorization dates to the correct surgery date.

Kay thanked me for keeping such a good eye on my paperwork. I have to say that everyone needs to read the invoices and all letters when it comes to insurance or bills from the doctor. I always pay attention to what I get because there are always mistakes. I have had to call and fix things more than once and the end result meant I didn’t have to pay the amount that I was billed for. Kay has so many people to do this for that I am sure she can’t catch all the mistakes.

The out of network percentage that I would have to pay would have been 30% and the out of pocket year maximum is $2000. So I would have had to pay a lot more considering I have already met the in network out of pocket maximum of $500.

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