Not In Good Insurance Company, Part 2

(I work in the business office of a specialized eye care clinic. We often get calls from people who are confused by their statements, since we switched to a new system halfway through the year. )

Me: “[Business], this is [My Name]. How can I help you?”

Woman: “Yes, I’m calling about the bill I received. I already paid this, and you fools are still charging me!”

Me: “Let me take a look at your account. Can I have your name, please?”

(She gives me the name of the account, and I pull it up in my system.)

Me: “It looks like the bill is due to an office visit that was done in November; the insurance company did not cover the whole cost.”

Woman: “See, that’s the thing, you idiot. I wasn’t supposed to have that visit. I just needed a referral, and the stupid doctor forced me to come in. I don’t think I should have to pay.”

Me: “Well, it does look like a full exam was done, and so you would need to pay for services that you received.”

Woman: “Are you a f****** r****d? I just said that I shouldn’t have to pay for it because I didn’t want to come in! Jesus, I can’t believe how stupid you people are! The damn doctor made me come in to get my damn referral, and I shouldn’t have to pay because he just wants to make more money off him. Reverse the charges right now!”

Me: “I’m sorry to hear that, but from what I’m able to see, it does look like services were performed, and not just a referral. I’ll need to check with my supervisor and the doctor to see what we can do.”

(I explain the situation to my supervisor, and we both go talk to the doctor. I tell him what’s going on, and give him the name. He sighs.)

Doctor: “Obviously she thinks I don’t remember the visit, but I do. She skipped four visits in a row, so I didn’t know she needed a referral until she finally came back in and I checked her out. Tell her to send a check in and pay us, for God’s sake.”

Me: *I call the woman back, to tell her the outcome* “So, I did speak to the doctor and my supervisor, and that visit will need to be paid for, as the doctor was not able to refer you until he could examine your eyes.”

Woman: “Well, I suppose I’ll arrange for some money to be sent in. But I’m going to tell my insurance company about you and your ways!”