Phone Again About The Phoney Claim

| USA | Working | August 5, 2013

(For several months, I have been running around in circles trying to figure out why the hospital keeps sending me a bill for services when my daughter was born. I already have a letter from my insurance company saying the bill has already been paid for in full.)

Insurance Agent: “Okay, I’m looking at the billing history, and I can see we did pay the full amount for all charges and services at [hospital], from [date], until [date].”

Me: “Yes. That is exactly what I have on my statement from you. But according to the hospital, they are still saying you have been rejecting their claim. I have the bill from them with the rejected information.”

Insurance Agent: “Right, let me take another look here… Hmm… uh? Oh, that’s not right. Ma’am, I think I found the problem. Can you look at the top of the rejection form, and see if you can find the filing number on that claim?”

Me: “Yes, it says [number].”

Insurance Agent: “I see. I found the problem, ma’am. The rejected claim was rejected because the hospital tried to bill you once under your name, and then again under your newborn daughter’s name.”

Me: “They what!? How can you tell?”

Insurance Agent: “Don’t worry. Unfortunately, this happens a lot but often gets missed. Since your daughter does not have insurance through us, the claim was rejected. Don’t worry though. I think I can fix this problem for you.”

Me: “That’s so great! I’m so glad we found the problem, but you don’t mind if I call the hospital billing department, do you?”

Insurance Agent: “Well, we can certainly fix this without you having to do anything, since this is not your fault. May I ask why you want to call them?”

Me: “The people from the hospital billing department have been harassing me for months about giving them false information, and warning me that insurance fraud is a very serious crime. I can’t wait to ring them and tell them I found out they were the ones trying to scam you!”

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