There’s a lot going on here, and I’ve been trying to navigate it, but the tl;dr is at what point can I really be charged for what my insurance is liable for due to multiple incompetencies on the provider’s and insurance’s end?
I’m on two insurances. My parents only covers a small area where I do not live, so my husband added me to his so I could give birth in a hospital my baby could be born in. They won’t let me off of my parent’s insurance and it has to stay the primary insurance, so everthing gets sent to them, usually denied, then sent to my “actual” insurance.
I started at a therapist last year, we hit our deductible, so it was 100% covered, great. Except a month ago the office reached out to let me know my appts moving forward would be cancelled due to an outstanding balance because they have received no money from my insurance, unbeknownst to me. I even had a secretary tell me insurance was great for covering all of it.
I call my secondary insurance, they haven’t gotten claims because ny primary insurance hadn’t closed it out and sent it to them. They said they had, but because it was out of network(surprise, they’re actually covering some of it), they can only send a check to the policy holder (my dad).
My parents had received no checks for my therapy office so I had them resend them, which they claimed to do. I finally got one check with the wrong name and after contacting the office realized the claim was submitted with the wrong name, the name of someone who worked at the office, but no longer did, and who I had zero interactions with. They say no problem, send the checks anyway, they’ll get her to sign them over.
I call insurance, let them know to proceed, ask them again if they can send it directly to the provider, or at least to me, they tell me no, but they’ll send checks to my dad again. Fine, whatever.
Time has passed, no new checks have come. I call today, apparently they have been sending money to the office in a direct deposit, only problem, the office has gotten no money except for the check I’ve given them.
Every time I call from both sides I’m getting reminders if I don’t get the other side to sort it out in time I’m going to be responsible to pay it. How realistic of a threat is that? I’m fuming because I’ve invested countless hours into this, been told different things every time I’ve called, been playing catchup for others’ mistakes. The year mark is fast approaching and I’m losing it at the idea that I’m going to have to cover something I’ve been paying insurance to cover because the office can’t submit a claim correctly and insurance can’t figure out how to write a check! If it were truly the case can’t every insurance just play the long game and fumble the bag for a year until they’re no longer liable? What are my options aside from hoping some miracle sorts this out? I keep feeling like I’ve done something wrong but I can’t figure out what it is!