coinsurance

May Financial Update

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After not wanting to know the details of March’s expenses because Mr. ODA threw me a surprise party, I was pleasantly surprised to see our spending in April. Now, with that said, while my categorization of expenses cover April 1-30, my stories here go through this date in May. And May has been a doozy.

We changed our insurance carrier as of May 1. We put a concerted effort into getting some routine things out of the way before our insurance changed because we weren’t too confident in the new policy’s coverage. Mr. ODA got a physical. I got an eye exam, which is more expense ($116) due to the contact fitting, and became more expensive when we moved on to acknowledging the astigmatism that we’ve ignored for the last 5 years because it’s so slight. Then that leads to buying contacts ($300). I do need to submit the reimbursement request for the contacts that I paid out of pocket for, so at least some of that should come back.

In mid-April, I started having chest pain. That lead to us wiping out the deductible. Such unfortunate timing. We could have walked away from that policy only needing a couple of hundred applied to the deductible, and then I didn’t take care of myself while sick, so the virus attacked the wall of my heart. Lovely. My first office appointment was at a new clinic, and they said if I paid in full, they’d apply a 10% discount. I’ve had to learn to navigate the world of medical billing (even more in depth than I already had due to poorly executed claims) because of the deductible concept. So the lady’s statement was correct – I still owed about $3000 on my deductible. That’s what she billed me. That’s a normal statement for me to hear. What I hadn’t thought about was – but who will get there first? If her claim wasn’t first in line, then my deductible payment wouldn’t go to her. Narrator: she was not first in line. So now I’ve paid $3k to this company, but I only actually owe her about $900. Meanwhile, the one who was first in line now wants their payment, understandably. I’m trying to hold off on that until after the 20th so that it’s on the next credit card cycle. And through all of this, I also need to fix my log in to my old insurance account to be able to verify that they’ve even accounted for my deductible correctly because I swear I’ve overpaid my deductible the last two years due to too many claims happening at one time, but it’s convoluted and I’ve just given up tracking it both years (I know, this is against everything I tell you to do, but shew, it’s been quite the year or so around here).

On top of that, Mr. ODA works at Lowe’s, and they have a spring holiday period where employees get a 20% discount. So now there’s a ton of Lowe’s transactions on our credit card that’s inflating our spending. While the details of that will be in next month’s update, it is reflected in the net worth calculation I have here since these are current numbers.

RENTALS

We got one house rented as of May 1. That was an anticipated project, and the tenant who left had lived there for 6.5 years. We were gone the first week of April, so we ended up losing the month of income, but the actual work to turn it over took very few hours (at least compared to most of the turnover we do). There’s one more house outstanding to know if she’s renewing, and there’s one house that will turn over at the end of June. That woman moved in over the winter on a 6 month lease. She’s been extremely difficult, and I’m not sad to see her go. For instance, it’s the 22nd, and she still hasn’t paid May’s rent. The good news is that the turnover should go quickly since we did a massive effort to spruce it up at the last turnover.

NET WORTH

The market has recovered a bit, so we’re trending up again instead of stagnant on the net worth. I categorized our spending for April, but since we took a trip, the ‘entertainment’ category is taking over the graph.

I took out the expenses related to our trip to see what was left. Entertainment is still high because we spent $785 on season passes for skiing next year. This also include our daughter’s gymnastics and our gym membership. Just funny that the graph didn’t change because our proportion of spending was the same.

Over the past few months, I’ve worked on increasing our monthly cash flow a bit with rent increases. This isn’t a money-maker, but just trying to stay on top of the routine cost increases (e.g., taxes, insurance) that are coming our way. Once all the increases go into effect, it’ll be another $400 per month. But that’s also contingent on what we get the house that’s turning over rented at. That seems like a lot, but you’d be surprised at what our cost increases are. I usually do a post comparing all those changes in the Fall.

This month our cash went down too because I had to pay the health insurance costs and three houses worth of taxes. I updated our home values now that it’s the spring market; I update these numbers about twice per year.

Medical Bills – Part 2

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I went to the emergency room on November 15, 2021. I resolved a bill from that day on June 30, 2023.

The provider submitted a claim to my insurance company immediately after my stay there. The submitted charges were $1526. My insurance adjusted the amount, paid about $1100, and said I was responsible for about $60. My explanation of benefits (EOB) even included a copy of the check they submitted to the provider, which is not typical. The check was date December 21, 2021.

The provider submitted a second claim, exactly the same as the first one, to my insurance company in December 2021. My insurance denied the claim because it was a duplicate. Simple enough.

The provider only received the denial, and not the check nor first EOB.

I received a bill from the provider in March 2022 for $1526. That didn’t make sense. I knew my insurance should cover most of a claim. I looked through my insurance coverage and confirmed I would only owe my co-insurance since our deductible had been long met. I reviewed my EOBs and noted the duplicate submission, so I called the provider. I told her the story, but she kept talking over me and not hearing that the denial was because it had first been paid. She said she was going to call my insurance company. I filed the paperwork and assumed it would get handled or that I’d receive another statement prompting me to take action.

In August 2022, I received a letter from a collections agency. I was pretty mad. Not only did I not receive information from this woman who had a job to do, they never sent another invoice/statement/bill to me.

On September 1, 2022, I called the collections agency as the letter told me to, plus I wanted a record that I had acknowledged the collections notice. The collections company told me to detach the part of my letter that had my information and mail it back to them asking for details. I did that immediately. I later received a letter that said “physician says you owe $1526 for services rendered on 11/15/21.” Thanks; that’s useless.

The same day that I called the collections agency, I called the provider. The man I spoke to told me he took my account out of collections status and would look into it. He told me to send an email to them with the EOBs and an explanation of what happened, which I did immediately that day.

On October 13, 2022, I hadn’t heard anything. I had sent two more emails since that time, trying to avoid a phone call, but at this point I had to call. I figured at any given moment, these people would just send my account to collections instead of put any effort in. The person I spoke to this time said they’d escalate this to the posting team for review, and they’d need 45-60 days to research it.

Nothing.

In December I called again. I asked for a supervisor immediately to avoid having to explain the story once again, but they made me explain it again. I got through to a supervisor who finally understood the story that there is a check out there for them. She said she sees that the issue is that the PO Box was wrong for where it was sent. She said she would contact my insurance about it. She emailed me the next day to say she tried 3 times to get to my insurance and couldn’t. That’s complete bull. I’ve never not been able to reach someone at my insurance agency via their 800 number.

I responded to her email 3 times asking for an update through December and January. At the beginning of February, I finally called again. This time, I called my insurance company and asked them what can be done. She called the provider via a 3-way call. The man said they’d resolve it and he escalated it. Same. Old. Story.

I gave them another 60 days and called them in April. Nothing different. This supervisor told me that she could see it being worked on and moving through the system. She said she really needed to allow it to work through the system and to give another 60 days.

I called on June 29, 2023. I was able to get through to the same supervisor as the April call. She kept me on hold a majority of the time. After a half hour, she came back and said “I’ve escalated this to the posting team. I appreciate your patience, but I really need to give them another 60 days.” No. Unacceptable. I’ve wasted hours of my life trying to get this resolved, and it’s not even my problem to resolve. It has only become my problem because they sent me to collections. I told her to send me to someone higher than her, and I was done being thanked for my patience.

A new person got on the phone. I said the only acceptable outcomes at this point are 1) you wipe the slate clean and call it a wash because you’ve had more than enough time to ‘find’ the payment from my insurance company, or 2) you call my insurance company and get them to stop payment on the previous check and reissue payment somehow. She said she’d look into it with the posting team. I said “clearly, the posting team doesn’t know how to do their job, and I’m tired of being told for an entire year now that we’re waiting on them to find the payment.” She agreed.

She looked at some screen and something clicked. She said that the payment was processed through a third party, so they take a cut of the check from the insurance. All this time, they’ve been looking for $1100, but they should be looking for something less than that. She called the company that processed the payment, found out the amount they sent to the provider, found the payment amount in suspense, and applied it to my account.

That left a balance of $60 owed from me, and she graciously zeroed that out for my troubles. I didn’t have a problem paying $60, but I did have a problem with their way of handling this issue.

I had heard from someone two other times that sounded like they were actually going to help me. I had no faith that this was the end of the road when I hung up the phone on 6/29. I started to look for alternative courses.

I submitted a claim to the Better Business Bureau. They accepted my complaint within a few hours, but I ended up calling to withdraw the complaint on the following morning since this woman fixed my issue finally.

I called the Federal No Surprises Help Desk. Truly, I didn’t think this counted because it wasn’t “surprise billing.” However, they have a system that asks you questions and gives you a course of action. In my case, they said to call and start a claim. Unfortunately, I did call, and she said that since the date of service is before the No Surprises Act was established, she couldn’t help me.

She suggested I call a number in Kentucky for my issue. I called and left a voicemail, but that felt weird. I looked up some options specific to my state, and there was a way to file a complaint with the Attorney General. I submitted that complaint, which I need to figure out how to withdraw now.

I’m skeptical that this is over. The lady I spoke with said she will send me a zeroed out statement in the mail, so I’ll be holding my breath until that actually shows up.

There are so many times where I, as a consumer, am just stuck. I don’t understand. The consumer has no help or protections that are easy to find or take advantage of. I just have to keep calling this company and hope that eventually they resolve it. Yet they could send me to collections and completely ding my credit worthiness, even though this was their issue and fault.

Nineteen and a half months after my date of service, I may actually have this resolved. This was a bill for $1526. A lot of people don’t have that kind of money to erroneously hand out. I hope that someone reads this and thinks before they pay their next medical bill to ensure that it’s accurate and truly the amount that’s owed.