Three years ago I took my son for an extensive psych evaluation for behavioral issues he was having in 2nd grade. He's much better now but that's irrelevant. Anyway, I met with a Neuro Psych that said she is a Tricare provider (Military Ins that my ex had him on at the time) so I paid an out of pocket fee, probably around $200-500, can't remember since it was so long ago, and agreed to go ahead with the evaluation. Thought everything was taken care of and never heard anything from them again.. life went on. I get an EOB in the mail yesterday (three years later!?) stating that the provider was not Tricare certified at the time of service so the $3,450.00 bill will not be covered. Um..What!? I contacted the billing dept at the Psych office immediately and VERY bluntly stated that their mistake won't be mine to fix. She wrote me an email back stating the office "probably won't bill me for this, they're just hoping Tricare will pay something but I would be responsible for whatever my in network fees are". She said she's waiting to hear back from the Doctor and will contact me Monday.
Someone made a huge screw up and that's frankly not my problem. How does a Doctor not know who they are/aren't in network with?? Honestly, I have better things to do than constantly deal with other people's incompetence...and this is the 2nd time this has happened to me, last time was with a different insurance. I fought/won the last time and plan to fight again.
I worked in medical for 15 years and won't deal with this BS. Game on.
Definitely fight that! I had something very similar many years ago. I made an appt with a gyn in a group. After the visit they informed me that the doc I saw was the only one that did not accept my insurance in that group. Needless to say I refused to pay the bill and they agreed so no fight was needed thankfully.
Its very odd they contacted you 3 years later. Its sounds like they billed you hoping that you would just pay up, but if you refuse they won't push the issue. That is kind of frustrating too, no? That their first plan was too hope you were too stupid to question the bill and just pay! I find that kind of slimey...
Let us know how it turns out.
If you just received the EOB, it sounds like they just billed Tricare. With most insurances (except Medicare) you have 45 days to file a claim. Medicare is a year. I don't know of ANY insurances (govt or private) that you have 3 years to bill the insurance. Definitely, not your problem.
Unfortunately, most providers don't know what insurances they do/don't take. They leave that up to the business office.
That happened to us once only it was 4 years later. That's some kind of incompetence. Anyone who thinks I'm paying that nonsense has another think coming!! My husband's employer at the time would change insurance companies every single year at renrollment; so that was like 3-4 insurance companies prior and I was like whatever...your problem, I'm not paying that.
It's Tuesday and still haven't heard back from the lady I spoke with in billing. This is kind of important, no? lol
I will deal with it if/when they send me a bill but I'm not contacting her again in the meantime. Not my problem.
This is not the first EOB. I got one soon after service but can't remember details. Obviously Tricare didn't pay, they realized they screwed up by telling me it would be covered and put it aside for 3 years. Somebody probably finally caught it and told them to resubmit in hopes they would pay something. Regardless I'm not going to get stuck with it.
Rant
