Our tech team has launched updates to The Nest today. As a result of these updates, members of the Nest Community will need to change their password in order to continue participating in the community. In addition, The Nest community member's avatars will be replaced with generic default avatars. If you wish to revert to your original avatar, you will need to re-upload it via The Nest.
If you have questions about this, please email help@theknot.com.
Thank you.
Note: This only affects The Nest's community members and will not affect members on The Bump or The Knot.
Am I beating a dead horse here...
Ds has been seeing a gastro doctor because of come chronic issues that get him sent home from daycare when he's not sick. Seeing as he's so young GI doctor said he thought it would be in our best interest to have DH and I do a lactose breath test to rule out a possible inherited lactose intolerance. He said he'd have his assistant call us to schedule and she did.
On 10/4 we went to Fairview UMP in MPLS for this excruciatingly long test where we sat in a chair in the waiting room for 4 hours and breathed into a bag once every hour after drinking straight lactose...well nothing came of that, neither DH nor I are lactose intolerant...unfortunately now I am saddled with a $604 bill because it was billed as an outpatient hospital charge and that goes against the deductible.
I am currently fighting it with Medica in hopes that I can get them to reduce the charges, especially since I've talked to all parties involved and found out that the test could have been done in a "clinical" setting and then it would have been billed as an office visit...instead of being done in a "hospital based clinic" and being billed to our deductible.
Is it a waste of time for me to continue fighting this. I am in the appeals process with Medica, and once that's through I can appeal it with Fairview themselves, and do a secondary appeal through Medica.
I think there wa a lot of mis-communication surrounding this appointment and I also don't have $604 dollars just lying around to pay for the worlds stupidest test.
So should I fight or not???
Re: Am I beating a dead horse here...
well, i would say fight it as much as you can but ultimately, you're responsible for knowing what your insurance covers and for asking questions to make sure you get the care that fits within your plan. IT'S TOTALLY NOT FAIR and i agree but that is what they always say. you have to be an informed consumer.
keep fighting it. hopefully you'll get someone to give and you'll end up with a much smaller out of pocket expense.
I would fight it.
Also- did you check for Gluten Intolerance or Celiacs?
This is exactly why I am on the fence because I should have checked it and been informed, but I didn't...but I also wasn't told that maybe I should check it, I guess I just assumed it was a minor test and it would be covered. and the test itself WAS covered just not the facility fee...so sitting for 4 hours in a hospital vs. a clinic is what's costing me the money.
When I talked to the clinic manager she said that the scheduler SHOULD have said to call insurance and verify coverage, but when I talked to said scheduler she took the stance that "its not my responsibility to tell you that, you should know you're coverage level." And that pissed me off.
Yep we tested for that. We actually did some genetic testing and he did test positive for one Celiac marker. It doesn't mean he has it, but it doesn't mean he doesn't have it...apparently statistically speaking about 85% of the population has this positive marker and doesn't have Celiacs. We're going to watch him going forward and see if we see a change.
He isn't overly concerned right now because he's still growing normally, and eating normally. He just has a huge issue with bowel movements and belly being distended a lot.
As a medical freak show who has spent more hours dealing with insurance than I could possibly count, I'd say you're pretty much hosed. You can, however, do small payments of like $50/month til it's paid off. Demand that if nothing else.
The SINGLE time I was able to remove a dr bill was when I called an eye dr and specifically said I had X insurance and needed a dr who took X insurance. The scheduler 100% at fault gave me to a dr who didn't take it. The office manager was willing to take off the charge since it was literally not my fault but the scheduler. It greatly helped I was at target HQ where tons of their customers also went, so the office manager knew her person was the wrong one and knew I called their clinic because it was the closest to HQ.
I'm grateful my dr said not to test our girl for lactose intolerance. We just started giving her lactose free milk and her problems vanished so it was easy and no testing needed.
Good luck on your wild goose chase to figure out what's going wrong!! And if it makes you feel better, I have a $5,000 deductible, so we're paying off $700 for an OB, $250 for a head cold /infections requiring 3 drugs, and going to the dermo for my son where it'll be $200 and I'm going to BEG her to scrape his mole THEN instead of go BACK for another $200 to test it. I hope I can do this without getting upset in front of my kid... argh!
Agreed. Next time do the research on the front end (as frustrating and difficult as it can be).
That said, based on what I've heard from others, it wouldn't hurt to ask them to a) let you set up a payment plan or b) give you a discount if you offer to pay the bill up front.
Good luck!
margaritas in mexico
Unfortunately, I think you are in for a losing battle. My DS goes to the pediatric ophthalmologist at Fairview UMP. Every 6 months, he literally is seen for 5 minutes. I get a bill for appr $200 after insurance for the doctor's time, and a $400 bill for the Fairview building charge. It makes my blood boil every time, but at least it's only 2X a year. When DS was 1 yo, it was every 3 months.
I've tried talking to Fairvew UMP billing department about how in the world it could possible cost $400 for a 5 minute appointment, but that's the charge. I would probably just pay it. G/L!
Nicole and Sam 10/3/09
I should clarify after reading the rest of the responses and say I would fight $600 if I was sure I was in the right. I'm not convinced you are in this case.
Is the scheduler required to urge people to contact insurance every time or is that just a courtesy some do because they suspect the people might not be covered...?
I hate insurance. Ugh.
I hope you find answers about your son's health soon.
I totally empathize!
In August, DS needed an MRI. Long story short, the financial services branch at the clinic did a terrible job and were rude in our trying to find out if we'd be paying an arm and a leg for the scan. We called the insurance and they asked us a bunch of questions about the details of the MRI that the doctor or staff needed to answer, so when we went back to them to ask them to call (as per their JOB), they were snippy and told us it was our responsibility to find out the cost. We told them that they requested to talk to the doctor for the details and just went around and around about this crap and it was SO frustrating!
Ultimately, insurance covered it, but I totally feel you on how frustrating it is to attempt talk to professionals in the field who will actually HELP!