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Surprise Medical Bill for Mammogram

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PitterPatter11
Baby Boy is Here!

Member since 5/11

7612 total posts

Name:
Momma <3

Surprise Medical Bill for Mammogram

I’m 40. I just had my first mammogram. The place I went to says they accept my insurance on their website and my health insurance site lists the doctor at the address being in network as well. I just read my EOB after getting a bill from the provider for $650 since they are *not* in network. WHAT??????

I got this bill too late to call either place but is this real life? I thought mammograms were covered. I’m obviously disputing this bill.

Posted 8/23/22 5:56 PM
 
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LuckyStar
LIF Adult

Member since 7/14

7272 total posts

Name:

Surprise Medical Bill for Mammogram

The same thing just happened to me with an urgent care visit. After 6 phone calls it turned out someone at my insurance reviewed the claim and ticked the out of network box instead of the in network box so I got a bill for the full amount. It was absurd and literally took several hours to resolve. Call them and then argue it. I had 5 people insist it was out of network and there was nothing they could do until I finally pressed so hard the sixth person looked further into it.

Posted 8/23/22 6:31 PM
 

NervousNell
Just another chapter in life..

Member since 11/09

54917 total posts

Name:
..being a mommy and being a wife!

Re: Surprise Medical Bill for Mammogram

This happens a lot. They are coding it wrong or something
Call your insurance company to confirm but they will probably have you call the doctor/mammo place to have them look at how they submitted it and re-submit the claim

Posted 8/23/22 6:53 PM
 

PitterPatter11
Baby Boy is Here!

Member since 5/11

7612 total posts

Name:
Momma <3

Surprise Medical Bill for Mammogram

Update:

Insurance says a provider there does take my insurance. It was submitted though out of network.

Provider: we submitted it as in network but will resubmit.

Me: so I’ll be dealing with this for a while until it gets resolved. Lol

Posted 8/25/22 8:01 AM
 

NervousNell
Just another chapter in life..

Member since 11/09

54917 total posts

Name:
..being a mommy and being a wife!

Re: Surprise Medical Bill for Mammogram

Posted by PitterPatter11

Update:

Insurance says a provider there does take my insurance. It was submitted though out of network.

Provider: we submitted it as in network but will resubmit.

Me: so I’ll be dealing with this for a while until it gets resolved. Lol



LOL. I had to deal with a bill for a hearing test for my daughter for over a year. It got sent to collections too as I continued to fight it.
It got to a point where I had a standing reoccurring appointment in my calendar every week to remind me to either call the insurance company or the doctor's office.
It became like a part time job for me.
The next year when she went for her well visit I told them please do NOT do the hearing test. I can't handle another year of this.
It's amazing the incompetence when it comes to something as simple as coding a procedure.

Posted 8/25/22 8:21 AM
 

PitterPatter11
Baby Boy is Here!

Member since 5/11

7612 total posts

Name:
Momma <3

Re: Surprise Medical Bill for Mammogram

Posted by NervousNell

Posted by PitterPatter11

Update:

Insurance says a provider there does take my insurance. It was submitted though out of network.

Provider: we submitted it as in network but will resubmit.

Me: so I’ll be dealing with this for a while until it gets resolved. Lol



LOL. I had to deal with a bill for a hearing test for my daughter for over a year. It got sent to collections too as I continued to fight it.
It got to a point where I had a standing reoccurring appointment in my calendar every week to remind me to either call the insurance company or the doctor's office.
It became like a part time job for me.
The next year when she went for her well visit I told them please do NOT do the hearing test. I can't handle another year of this.
It's amazing the incompetence when it comes to something as simple as coding a procedure.



I could understand for an irregular procedure or a small insurance company, but I got a routine mammogram and have a big national insurance company. It makes no sense. I like how it’s my issue that these people are incompetent. Hundreds of women with my insurance must go to this place for mammograms.

Posted 8/25/22 3:23 PM
 
 

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