Now that I am intensely focused on budgeting income and expenses, I am paying much more attention to what things cost. I double check medical bills to make sure that our insurance was billed accurately, and to check for accounting errors. I am amazed by how many errors are made on a regular basis in the medical billing profession. One time I was sent the full bill for a clinic visit, just because someone forgot to bill the insurance company at all. Another time, I was sent a bill for a copay that was paid by check. The check was cashed and cleared my account, and I had record of it! For the most part, folks have been friendly when I call to report an error. They usually apologize for the oversight and assure me that they are submitting the correct paperwork immediately.
I have also noticed a trend of folks blaming the insurance company first, and suggesting I call the insurance company before they are even willing to take a look at the error. I know that medical insurance companies are not favored these days, so it is easy to be mad at them and speak poorly of them, and no one will disagree. My experiences so far pile up the most billing errors in the hands of the person who received our file immediately after the doctor is finished. I am not yet clear who that person is, but he/she is not very diligent in their job. I am sure it involves a lot of data entry, which is very boring. But, it so important for that person to enter the data correctly, so that the insurance company will have all of the necessary information to process and pay the claim.
The folks I am most suspicious of recently are in the pharmacy. I've noticed that the only financial information I receive from them is listing the cost of the prescription co-pay. I do not receive any information listing the original cost of the medication, the percent my insurance company pays, or anything that I can use to check their math and make sure calculations are correct. I have also noticed that different pharmacies in town charge me different copay amounts for the same medication. That seems suspicious.
Last week, I had a run-in with a pharmacy tech that wasn't very cordial. The pharmacy gave me a half-filled prescription, because they did not have enough in stock. I was irritated that they did not tell me this in advance, so that I could choose to go elsewhere to get my prescription filled, so they received my feedback on that. Then, when I went back to get the second half of my prescription, I was told I had an additional copay for the medication. Even though I was picking up half of the medication each time, the two copays were not equal.
When I asked why I was not charged in full the first time, I was told that it was illegal to charge me for medication I did not receive. Hmm? Well, then why is it legal to charge me 80% of the cost of the medication, but only give me 50% of the medication? Then, when I return, charge me the remaining 20% of the cost to receive the remaining 50% of the medication???
Since Jersey #5 is allergic to the medicine, I did not need to pick up the remaining half of his prescription. So, in the end, I was charged 80% of the cost, but only received 50% of the medicine. The pharmacy simply re-shelved that med and will sell it to someone else for its value. By my calculation, that gives them the 30% as profit, because they are able to double charge for that same bottle of medication.
The pharmacy tech was more than willing to blame my insurance company by telling me that she can only enter the information into the computer, and the computer spits out the copay amount that the insurance company says I have to pay. She suggested if I had a problem with that, I should take it up with my insurance company!
Um, yeah. MY solution was to request that the tech place a note in my file that states I do not want partially filled prescriptions. I want to be notified in advance when they do not have my prescription in stock, so that I may take my business elsewhere. I live in a big enough town to have plenty of pharmacy options. I can exercise my consumer privilege in order to cut down on such pharmaceutical embezzlement!
Realizing my own advice, I see that it is time I shop around for better pharmacy prices and service if both can vary that much from store to store.
It is amazing what I learn when I start telling my money where to go, instead of asking where it went!
I have also noticed a trend of folks blaming the insurance company first, and suggesting I call the insurance company before they are even willing to take a look at the error. I know that medical insurance companies are not favored these days, so it is easy to be mad at them and speak poorly of them, and no one will disagree. My experiences so far pile up the most billing errors in the hands of the person who received our file immediately after the doctor is finished. I am not yet clear who that person is, but he/she is not very diligent in their job. I am sure it involves a lot of data entry, which is very boring. But, it so important for that person to enter the data correctly, so that the insurance company will have all of the necessary information to process and pay the claim.
The folks I am most suspicious of recently are in the pharmacy. I've noticed that the only financial information I receive from them is listing the cost of the prescription co-pay. I do not receive any information listing the original cost of the medication, the percent my insurance company pays, or anything that I can use to check their math and make sure calculations are correct. I have also noticed that different pharmacies in town charge me different copay amounts for the same medication. That seems suspicious.
Last week, I had a run-in with a pharmacy tech that wasn't very cordial. The pharmacy gave me a half-filled prescription, because they did not have enough in stock. I was irritated that they did not tell me this in advance, so that I could choose to go elsewhere to get my prescription filled, so they received my feedback on that. Then, when I went back to get the second half of my prescription, I was told I had an additional copay for the medication. Even though I was picking up half of the medication each time, the two copays were not equal.
When I asked why I was not charged in full the first time, I was told that it was illegal to charge me for medication I did not receive. Hmm? Well, then why is it legal to charge me 80% of the cost of the medication, but only give me 50% of the medication? Then, when I return, charge me the remaining 20% of the cost to receive the remaining 50% of the medication???
Since Jersey #5 is allergic to the medicine, I did not need to pick up the remaining half of his prescription. So, in the end, I was charged 80% of the cost, but only received 50% of the medicine. The pharmacy simply re-shelved that med and will sell it to someone else for its value. By my calculation, that gives them the 30% as profit, because they are able to double charge for that same bottle of medication.
The pharmacy tech was more than willing to blame my insurance company by telling me that she can only enter the information into the computer, and the computer spits out the copay amount that the insurance company says I have to pay. She suggested if I had a problem with that, I should take it up with my insurance company!
Um, yeah. MY solution was to request that the tech place a note in my file that states I do not want partially filled prescriptions. I want to be notified in advance when they do not have my prescription in stock, so that I may take my business elsewhere. I live in a big enough town to have plenty of pharmacy options. I can exercise my consumer privilege in order to cut down on such pharmaceutical embezzlement!
Realizing my own advice, I see that it is time I shop around for better pharmacy prices and service if both can vary that much from store to store.
It is amazing what I learn when I start telling my money where to go, instead of asking where it went!
When I got half prescriptions at Albertson's, they didn't charge me until the second time. Walgreen's gives you a little more information than Albertson's (how much you saved), but since we have a flat prescription co-pay on many things, it didn't help me any (we pay x% or $6, which ever is less). It is eye-opening to see how much they try to change people without insurance though!
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