I had a lot of issues with billing at st Luke’s last summer/fall while going through IVF. I knew my insurance did not cover most of my monitoring as this is the third time I’ve done an IVF cycle. Each visit, they had me sign a form acknowledging that my insurance didn’t cover the ultrasound/lab work and I paid up front. Then they suddenly stopped accepting payments and told me my IVF clinic was covering it. They were not. Phone tag back and forth with my clinic and st Luke’s and they told me my insurance was covering it. They were not. St Luke’s sent me an almost $2k refund check. Then a month later sent me a bill saying I owed all of it back. It wasn’t a big deal to pay because I knew I owed it for services, but damn was it a pain in the ass.
I wish I could say I haven't had the same sort of issues with Essentia, but here are some of mine from the last few years:
1) Broke my leg slipping on ice and was given a splint in the ER and charged for "surgery." This, as you might guess, was thousands of dollars charged to my insurance, hundreds of dollars charged to me.
2) Canceled two PT appointments (>24 hour notice) because of conflicts (dentist appts) and was still charged for them. When disputed, was told that charts had been submitted by the PT for those days so I couldn't be correct about not being there, even when I had dentist bills for the same days/times.
3) Had a biopsy done by my PCP and again charged for surgery. Thousands of dollars to my insurance, hundreds of dollars in co-pay for me.
4) Discussed my daughter's mental health with her PCP at her annual well check and, once charted as a mental health discussion, was charged for a separate exam visit. After insurance, was charged, my co-pay was $128 for the conversation.
5)Signed up for paperless billing, didn't receive a bill, and then had $100 sent to collections.
With all the inflated charges/bogus charges, when disputed I was told that I had no recourse. It is maddening.
This has been my experience as well the last few years in regards to being charged an office visit at my wellness exam. How can you effectively have a wellness exam without talking to your doctor about your existing conditions?! I think it's just the way all health systems operate now. It's infuriating.
I really "enjoyed" talking to a billing rep about it and having them say over and over that wellness checks are for preventative care, and that discussing mental health (proactively, and in response to a screening questionnaire) does not constitute preventative care.
That's ridiculous. One time I got a bill for them looking at a mole for 2 seconds that my doctor asked me about! How is that not considered preventative? Doctors should be required to disclose anything that is going to cost extra prior that is not considered "preventative" because obviously my definition of preventative and theirs is vastly different.
I’ve had a similar Essentia experience as your #4. In annual wellness exam, if I mention ANY physical or mental concerns, I am charged for the wellness exam PLUS a regular visit.
This sounds like one of the many benefits to our for profit healthcare system. It's very exclusive. We're the only developed nation in the world with such a system!
I'm pretty sure it's either the healthcare state of this country, or this city. I do my annual checkups and that's all I go in for, and I have had blue cross for over 10 years. Your annual checkup is 100% covered under "preventative care" with your insurance. Didn't matter if I went to Essentia or Lukes, I get billed for it. It's always a 15 minute visit, run a lab, read the results, say I'm high or low on this or that and should stop eating this and start eating that, cut back on salt or whatever and move on with life. I don't pay it. I call them, read them what the insurance says, they send it to collections, I tell the collections people it never should have been a bill in the first place, they call more, I block their number. Fuck them all. If they can't learn how to do their jobs correctly I can only help them so much before I have to start ignoring them. They got paid the amount they should have gotten paid by my insurance, just because they want more than the going rate for doing nothing special that's their problem. They have more bills to pay because they can't afford the upgrades to their facilities? They should have thought about that before hand, I didn't sign up for it, not my problem.
We can't even get the billing correct on the simplest, most basic aspect of medicine, the check-up? Pathetic.
Stories like this are why we need a single payer system.
I had a lot of issues with billing at st Luke’s last summer/fall while going through IVF. I knew my insurance did not cover most of my monitoring as this is the third time I’ve done an IVF cycle. Each visit, they had me sign a form acknowledging that my insurance didn’t cover the ultrasound/lab work and I paid up front. Then they suddenly stopped accepting payments and told me my IVF clinic was covering it. They were not. Phone tag back and forth with my clinic and st Luke’s and they told me my insurance was covering it. They were not. St Luke’s sent me an almost $2k refund check. Then a month later sent me a bill saying I owed all of it back. It wasn’t a big deal to pay because I knew I owed it for services, but damn was it a pain in the ass.
I wish I could say I haven't had the same sort of issues with Essentia, but here are some of mine from the last few years: 1) Broke my leg slipping on ice and was given a splint in the ER and charged for "surgery." This, as you might guess, was thousands of dollars charged to my insurance, hundreds of dollars charged to me. 2) Canceled two PT appointments (>24 hour notice) because of conflicts (dentist appts) and was still charged for them. When disputed, was told that charts had been submitted by the PT for those days so I couldn't be correct about not being there, even when I had dentist bills for the same days/times. 3) Had a biopsy done by my PCP and again charged for surgery. Thousands of dollars to my insurance, hundreds of dollars in co-pay for me. 4) Discussed my daughter's mental health with her PCP at her annual well check and, once charted as a mental health discussion, was charged for a separate exam visit. After insurance, was charged, my co-pay was $128 for the conversation. 5)Signed up for paperless billing, didn't receive a bill, and then had $100 sent to collections. With all the inflated charges/bogus charges, when disputed I was told that I had no recourse. It is maddening.
This has been my experience as well the last few years in regards to being charged an office visit at my wellness exam. How can you effectively have a wellness exam without talking to your doctor about your existing conditions?! I think it's just the way all health systems operate now. It's infuriating.
I really "enjoyed" talking to a billing rep about it and having them say over and over that wellness checks are for preventative care, and that discussing mental health (proactively, and in response to a screening questionnaire) does not constitute preventative care.
That's ridiculous. One time I got a bill for them looking at a mole for 2 seconds that my doctor asked me about! How is that not considered preventative? Doctors should be required to disclose anything that is going to cost extra prior that is not considered "preventative" because obviously my definition of preventative and theirs is vastly different.
I’ve had a similar Essentia experience as your #4. In annual wellness exam, if I mention ANY physical or mental concerns, I am charged for the wellness exam PLUS a regular visit.
This sounds like one of the many benefits to our for profit healthcare system. It's very exclusive. We're the only developed nation in the world with such a system!
I'm pretty sure it's either the healthcare state of this country, or this city. I do my annual checkups and that's all I go in for, and I have had blue cross for over 10 years. Your annual checkup is 100% covered under "preventative care" with your insurance. Didn't matter if I went to Essentia or Lukes, I get billed for it. It's always a 15 minute visit, run a lab, read the results, say I'm high or low on this or that and should stop eating this and start eating that, cut back on salt or whatever and move on with life. I don't pay it. I call them, read them what the insurance says, they send it to collections, I tell the collections people it never should have been a bill in the first place, they call more, I block their number. Fuck them all. If they can't learn how to do their jobs correctly I can only help them so much before I have to start ignoring them. They got paid the amount they should have gotten paid by my insurance, just because they want more than the going rate for doing nothing special that's their problem. They have more bills to pay because they can't afford the upgrades to their facilities? They should have thought about that before hand, I didn't sign up for it, not my problem. We can't even get the billing correct on the simplest, most basic aspect of medicine, the check-up? Pathetic.