Why is medical insurance so high?

In the middle of July, I visited my doctor’s office. I had to do this in order to get refills for my blood pressure medications. Understandable. We do standard checks of pulse, weight, height, temperature, and blood pressure. We do “labs” to check blood sugar and cholesterol (etc.). I pay my “co-pay”, get my prescription renewals, and go on with my life.

Yesterday, I receive a “statement” from my doctor’s office (read as – I receive a BILL from my doctor’s office). Seems there was a “procedure” that my insurance company would not pay for. Evil Insurance company, right? Wrong! SMART insurance company!

The insurance company would not pay for “Smoking Cessation Intermediate”. Again – Evil Insurance company! Wrong! I am absolutely ELATED that my insurance company did NOT pay for this charge. Why, you might ask?

I called my doctor’s office – because I did not remember receiving any “smoking cessation” treatment while I was there. I thought, perhaps, it was a simple clerical error. I was mistaken. Apparently – when the doctor said,”You know that smoking is bad for you and you should really work on quitting.” THAT is “smoking cessation intermediate” and worthy of being billed to my insurance company as a $20 charge.

I, quite literally, LAUGHED at the administrative person I was on the phone with. “So – you mean to tell me – that one sentence from the doctor about ‘smoking being bad for me and that I should work on quitting’ is considered a ‘smoking cessation PROCEDURE’ and THAT is billable???”

She then said that she would “check with the doctor” as to what they wanted to do with this charge that “I” was now being billed for – because my insurance refused to pay it – and get back to me. It was late in the afternoon – so I really didn’t expect a call back that day.

Today – I received my call back. I was informed that they would just cancel the charge. Imagine THAT! They got caught having to explain how two sentences (barely) was considered a “billable treatment” – and so decided that they would just “cancel the charge”.

Lessons learned folks – ALWAYS ALWAYS ALWAYS check your statements from ANY doctor you go to and insure that ANY “treatment” you (or your insurance) is being billed for – is a “treatment” you actually “approved” and “received”. If you have a question about ANYTHING on your statement – call them and make them EXPLAIN the charge.

My insurance company had (apparently) seen through this blatant scam (or had dealt with it before) – and refused to pay for it. Good for THEM! They were looking out both for themselves and for all their members. Stupid/erroneous charges like this are a part of the reason that medical insurance is so high. I “get” that doctors want to be paid for their time/training/etc. – but something like THIS? I am sorry, dear doctor, but a 30 second conversation where you tell me “smoking is bad” and I should “work on quitting” is NOT a “treatment” and definitely NOT worth $20.

“In other news, water is wet.”

THAT statement has just as much treatment and procedure “value” as what you said to me and attempted to bill my insurance company (and then, in turn, me) for.

This entry was posted in Common Sense, Not Rocket Science.

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