Not Willing To Billing

, , , , , | Healthy | April 29, 2019

(I have medications being filled on a 30-day supply. My insurance company requires me to call every month and verify that I do need the medicine and that my health panel — age, weight, allergies, etc. — is up to date. I made my call earlier this month, letting them know that I would be on vacation when the medications were scheduled to be delivered and asked if they would deliver without requiring a signature. The representative said it was fine and told me that my medicine would arrive while I was gone. I asked my sister to check on the house while I was gone, specifically mentioning the delivery and the rough timeline I was given. When I come home, she tells me that there have been no deliveries. I call my insurance company again.)

Representative #1: “[Insurance], this is [Rep #1] speaking. Can I have your name and policy number, please?”

Me: “Hi, my name is [My Name]; my policy number is [number].”

Representative #1: “Okay, I have your account here. How can I help you?”

Me: “I was supposed to have some medicine delivered, but nothing has arrived.”

Representative #1: “Okay, I see here that we attempted to deliver on [date] but there was no one home to sign.”

Me: “I was told I could opt out of the signature because I was out of town.”

Representative #1: “No.”

Me: “…”

Representative #1: “…”

Me: “Can I get a new delivery scheduled?”

Representative #1: “I can add you on today’s shipment and overnight the medication to you at no additional cost.”

Me: “That’s great!”

Representative #1: “Okay, I just have to verify your info.” *we go through the same questions I answer every month* “Everything looks good. This will go out today for delivery tomorrow, with a signature required.”

Me: “Thank you!”

(The next day, I’m home all day and nothing comes. Since our package deliveries can come as late as nine pm, I’m stuck waiting all day before I can call back. The day after my delivery was to arrive, I call again. I get a different representative.)

Representative #2: “[Insurance], this is [Rep #2] speaking. Name and policy number?”

Me: “[My Name], [policy number].”

Representative #2: “Thank you, [My Name]. How can I help you?”

Me: “I spoke with [Representative #1] two days ago and was told I would have my medications delivered yesterday but nothing came.”

Representative #2: “Oh, I’m sorry about that. I see here that you tried to order [medication] on [date before vacation] and we tried to deliver but there was no one to sign.”

Me: “Yes. And I called again and was told it would be here yesterday.”

Representative #2: “I’m not showing anything like that but we can ship– Oh, wait. There’s a hold on your account for unpaid copays.”

Me: “Unpaid copays? I’ve never received a bill.”

Representative #2: “You should have received… two.”

Me: “I don’t think I did. Why was I not told of this hold when I called two days ago?”

(I open my online account to see past bills. There is nothing.)

Representative #2: “I’m not sure, ma’am. I only see a bill for $243 that needs to be paid.”

Me: “I’m confused. I’ve met my out of pocket deductibles. What is the bill for?”

Representative #2: “One moment, I can look that up for you.” *hold music* “I’m sorry, ma’am, I’m having trouble finding the specific bill.”

Me: “…”

Representative #2: “…”

Me: “So… what now?”

Representative #2: “If you want to pay in full, I can have your order shipped as early as tomorrow.”

Me: “Um… I don’t even know why I’m paying.”

Representative #2: “They’re unpaid copays.”

Me: “I’m looking at my online account and there’s nothing like that. How do I suddenly owe that much money?”

Representative #2: “Oh. Um. Hold, please.” *hold music* “Thank you for holding, ma’am. My supervisor is looking into this further. Unfortunately, we cannot authorize your medications until you pay your balance. I can take your credit card info—“

Me: “I’m not paying anything until I have an itemized bill.”

Representative #2: *huffs* “Hold.” *hold music* “Okay, ma’am, I’ve talked with my supervisor. Your balance is $243. Will that be card or check?”

Me: “That will be nothing until you tell me why I’m paying.”

Representative #2: *huffs again* “Ma’am. I am trying to work with you here. You owe copays. We cannot fill your prescriptions until you pay in full.”

Me: “And I will happily pay as soon as someone can tell me why I’m paying. I’m looking at my history right now. Not only is there nothing with a copay for the past six months, but all other bills are marked as paid.”

Representative #2: *clearly annoyed* “Would you like to speak to my supervisor, ma’am?”

Me: “Yes, I would.”

(Hold music.)

Supervisor: “Hello, [My Name]? I’m told you would like to speak to a supervisor. I’m [Supervisor].”

Me: “Yes, thank you. I called almost two weeks ago to have meds delivered. There was a miscommunication and they were not delivered. I called two days ago to have the same meds delivered as of yesterday, but they weren’t. I called today and found that I owe money and [Insurance Company] is withholding my medications until I pay. Nothing in my records shows any unpaid copay, so please tell me what is going on here.”

Supervisor: “I apologize for the inconvenience. Please be patient with me while I look into this further. Can I put you on hold?”

Me: *thinly veiled annoyance* “Yes.”

Supervisor: “Thank you.” *hold music* “Hmm. Ma’am, I apologize. I see the bill, but I’m not finding anything that it could be linked to. Unfortunately, I cannot authorize your prescription to be refilled until this bill is paid.”

Me: “Let me get this straight: your records show that I owe money. Yes?”

Supervisor: “Yes.”

Me: “You will not send my medication until I pay this bill. Correct?”

Supervisor: *uneasy* “Correct…”

Me: “But when I ask why you want me to pay, no one can tell me why. Am I wrong?”

Supervisor: “No, ma’am, you are not wrong.”

Me: “Can you see why I’m annoyed?”

Supervisor: “Yes. Please let me put you on hold one last time.”

Me: “No.”

Supervisor: “Ma’am?”

Me: “I will not be put on hold again. This phone call is already over an hour long. If you cannot tell me why I owe this money, I can only assume it’s a mistake on your end and I’m being billed for someone else’s medication or—“

Supervisor: “We are very thorough in our billing process and—“

Me: “—OR someone is committing insurance fraud and I’ll have to hire a lawyer to get this resolved.”

Supervisor: *panicked* “Um. No, no, that won’t be necessary.” *clicking keyboard* “I will see to it that your medication is shipped out today and I will put an override on the unpaid bill. I will continue to research this and get back to you as soon as I know what is going on. Is your number [phone number]?”

Me: “Yes, it is. Thank you.”

Supervisor: “Thank you, ma’am. Enjoy the rest of your day.”

(My medication was delivered the next day and yes, I signed for it. It’s been two weeks and I still haven’t heard anything about my mystery bill. I guess I’ll have to wait and see what happens when I call for my next refill!)

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