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I Made A Mistake... But I Think I Got My Approval :)



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My surgeons office had a list of suggested psych drs for the pre-op evaluation... so I called, they said they took my insurance, made an apt, paid my $25 copay, done. I thought. Today I got a bill for $250 from the psych dr, stating he is not a plan physician. I would think the dr office would let me know that before the apt, but nope. I should know better since I work in insurance, but for some silly reason I didn't even think about checking.... darn.

Also in the mail today is some kind of insurance approval letter, but the language on it is so confusing, I am not 100% sure. LOL!

Of corse Aetna Member Services and surgeons office is closed until Monday... so I wait. (Time is moving so slowly!!) Hahahah!

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so I called, they said they took my insurance, made an apt, paid my $25 copay, done. I thought. Today I got a bill for $250 from the psych dr, stating he is not a plan physician. I would think the dr office would let me know that before the apt, but nope.

Not only were you told they took your insurance when you set an appointment , but when you visited they took your copay and not full payment. They made TWO mistakes. I would call my insurance and then call them. I wonder if he was covered at the time of your phone call and visit. At a minimum, I would want a DEEP discount. I would fight it.

I have a PPO and I call my insurance for expensive things like surgery but not every time my daughter or I go see a new specialist. Like you, I call the doctors office and take the receptionists word. In the end I know I will be responsible financially, but I can't imagine calling my health insurance so often! Do others call every time?

Congratulations on your potential approval! :-)

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I agree they made the mistake in telling you they took the insurance and taking the copay. However, I do check my insurance website to make sure the doctor is in network.

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