Unfiltered Story #100578

Several years ago, I started to receive bills at my home in Nebraska from an insurance agency on a policy that I no longer had denying payment for psychiatric care/services. When I got the first bill, I called the number listed for the practice – in North Carolina. It turns out, that they had a patient with the same name, down to the middle initial, and the same birthday. The doctor’s office agreed that I was not their patient, but said that it was up to the insurance carrier to sort out.

Three weeks after I contacted the insurance company letting them know I was not the right person, I got a letter in the mail telling me that according to their records, I *was* the right person, and could I please pay the bill. So I contacted them again. I was assured that it would be straightened out.
Sure enough, I got another letter in the mail from the insurance company telling me that their “investigation” was complete, and that I was the “right” person after all, in spite of living half-way across the country.

This back and forth with the insurance company went on for 6 MONTHS, each time the insurance people coming back telling me that I had made these appointments for psychiatric care, and increasingly nasty demands for payment.
Finally, I contacted a college buddy who was a lawyer for [insurance company], where upon he taught me the magic words: Violation of HIPPA.

Finally after nearly 7 months, the magic words did the trick. I later found out that the Insurance Billing Department was looking up patient information by name and birth date instead of social security number, and that my name was apparently the first one listed, in spite of the fact that my policy had been cancelled over 4 years prior due to a job change.