Never goes smooth. How come it never goes smooth? Part zwei.

[Scout26]

So a couple weeks back at the Dialysis center for the monthly visit with the Doctor, Nurses, Social Worker, and Dietician.  Everything looks pretty good, and time to renew/refill a couple 90 day prescriptions. (Phosphorus binders*).  No biggie.

They send them to my mail order pharmacy that my insurance company uses (have used them before, never an issue).

Until I get a call from them. 

"Hi, once you send us a check for $3,500, we'll send your meds."

Uh, what was that number.

"You haven't met your deductible yet, so it's $3,500."

It's shouldn't be, simply because my first order of supplies normally exceeds that amount, therefore my deductible is usually hit by mid January.

Then I start getting bills from my Nephrologist, and the Dialysis place.   Something is seriously wrong.   Contact the Social Worker at the Dialysis place and we discover that on 1 Jan, UHC changed the group number on one digit in the middle of said number.  Where I didn't catch it, when they sent me my new card.  (The member# and other numbers did not change, so I thought it was the same.)

Needless to say when everyone sent their bills to UHC, they rejected them all as "No such member with that number", because everyone was using "last year's" number.

So I spent about 3 hours Friday morning with the Financial coordinator of the Dialysis place trying to explain to her to just send the bills through a again with "This Year's" number on them.  Her (sole and overriding) concern was that she did want to blamed for the mistake.  Look, sweetheart.  I screwed up.  Lack of attention to detail.  Write "Patient's Error" on each and every page.  I even write a letter to your higher up's, explaining my mistake.  Just make it happen.

First time, I've ever had a problem with insurance.  Why they changed the group number??  Who knows, and who who cares.  Just re-submit the bills with the correct number and let's get on with our lives.

SO once I get it straightened out, I have to start over with the meds etc.  (Fortunately, I have about a year's supply.  Yes, I am a hoarder, why do you ask?) 



* They have zero street value.  Unless you like soft, smooth, stools or ones that are black.   

[vaskidmark]

* They have zero street value.  Unless you like soft, smooth, stools or ones that are black.   

Shhh!  Ned might hear.

stay safe.

[Cliffh]

Yeah, we had the same problem this year.  Same company, new cards, new numbers.  Fortunately, on the first visit, they asked if we had a new card.  Handed it to them, they compared the numbers and nightmare avoided.

Gotta remember to check the numbers next year.

[erictank]

So a couple weeks back at the Dialysis center for the monthly visit with the Doctor, Nurses, Social Worker, and Dietician.  Everything looks pretty good, and time to renew/refill a couple 90 day prescriptions. (Phosphorus binders*).  No biggie.

They send them to my mail order pharmacy that my insurance company uses (have used them before, never an issue).

Until I get a call from them. 

"Hi, once you send us a check for $3,500, we'll send your meds."

Uh, what was that number.

"You haven't met your deductible yet, so it's $3,500."

It's shouldn't be, simply because my first order of supplies normally exceeds that amount, therefore my deductible is usually hit by mid January.

Then I start getting bills from my Nephrologist, and the Dialysis place.   Something is seriously wrong.   Contact the Social Worker at the Dialysis place and we discover that on 1 Jan, UHC changed the group number on one digit in the middle of said number.  Where I didn't catch it, when they sent me my new card.  (The member# and other numbers did not change, so I thought it was the same.)

Needless to say when everyone sent their bills to UHC, they rejected them all as "No such member with that number", because everyone was using "last year's" number.

So I spent about 3 hours Friday morning with the Financial coordinator of the Dialysis place trying to explain to her to just send the bills through a again with "This Year's" number on them.  Her (sole and overriding) concern was that she did want to blamed for the mistake.  Look, sweetheart.  I screwed up.  Lack of attention to detail.  Write "Patient's Error" on each and every page.  I even write a letter to your higher up's, explaining my mistake.  Just make it happen.

First time, I've ever had a problem with insurance.  Why they changed the group number??  Who knows, and who who cares.  Just re-submit the bills with the correct number and let's get on with our lives.

SO once I get it straightened out, I have to start over with the meds etc.  (Fortunately, I have about a year's supply.  Yes, I am a hoarder, why do you ask?) 



* They have zero street value.  Unless you like soft, smooth, stools or ones that are black.   

Thanks for the heads-up - my small-group plan (through my small-business employer) is through UHC, and will be renewing any time now. Better keep a sharp eye on my new card, I've already had trouble with a member number change once.

[AJ Dual]

Why they changed the group number??  Who knows, and who who cares.  Just re-submit the bills with the correct number and let's get on with our lives.

Because whenever they do something like that they can reject X% of claims and not have to pay them right away. And then only Y% of X% are NOT too lazy/incompetent to straighten it out, and either the patient, the provider, or a chain of collection agencies eat it.

The new numbering scheme probably superficially reflects "new software" a "new system" or some other process improvement, and probably even does so consciously within the insurance co. but the temporary increase in margin it represents is the real driver.