Office help issues

Hi, I'm am just starting the process with my doctors office. I saw the surgeon yesterday and everything went great. Until, the lady who sets everything up came in. She looked at my insurance card and said your not covered here. She was not hearing anything, but what she thought. I tried explaining that I had called the insurance company twice and had the names and dates I spoke to them. I told her exactly what they told me about my insurance being worldwide and that all the doctors in the practice were covered. She said because it was a different state, I was not. I then excused myself and call the insurance again. They again said you are more than covered and explained what to tell this lady. Anyway, I am now waiting for her to call back so we can discuss this. They have given me all the papers to start all my classes, and appts. But I'm afraid to set it up today. Has anyone ran into problems like this. I don't want to start over again looking for a doctor. I spent months finding the practice I felt comfortable with and they are the best in my area that I felt comfortable with. Thanks for reading, just could use some guidance and support.

Vicki

Just because the insurance company says you are covered, it doesn't mean that every doctor's office has to accept it.  Doctors can choose which insurance plans they want to work with.  I guess you should specifically ask the doctor's office-"Are you saying my procedure isn't covered by my insurance, or your office is unwilling to work with my insurance company?"

If they will not work with your insurance, your only option may be to find someone that will.

Hoping all goes well for you-don't give up!

Kim

Thank you for your reply. They accept my insurance. It's blue cross. They actual have special accrediations through blue cross for their practice. It's does not make sense. I will ask them that way you suggested. I'm waiting to hear back from them. I think part of the issue is that they are in Delaware and I'm from PA. I think they are having an issue with the processing schedule of it. Its not a difficult thing to do, but I also understand and respect that they do deal with insurance companies all the time.

 
They have dropped ALL insurances except for BC/BS; that is the ONLY one they still contract with. 

They may need a letter from the insurance company stating that you are covered in Delaware and with their practice.  Good Luck, sometimes getting through the red tape is the worst part of this whole experience!  

Just be persistent, especially if you know you are right and you have your heart set on Dr. Peters!!!!!

 I happen to know that much of the office staff is new at CHRIAS, including the insurance specialist.  Be patient and work on educating them.  I have BCBS of MD and they have been fine with that (of course I started like 4 years ago.)  They do take a while to call back, but if I were you I would go ahead and start scheduling appointments.  I know that there are a lot of new changes in their policies, but you are exactly correct to get it straight now.  Also, as you start with PMRI they may be able to help with things.

If necessary, print off the pertinent information from your insurance's website and take it in or email it to the insurance specialist (read heavy sarcasm there).

My surgeon's office has an insurance specialist/certified coder who is a moron. I cannot see why she is still employed but Dr Surgeon thinks she's the bees knees. She gave me incorrect information, but I was loaded for bear: I work in healthcare and take NO ONE's word for something--I get everything in writing.

You don't necessarily need to be as uptight as I am, but do supply documentation.

Realize you spend a lot of time dealing with the office personnel, maybe you should really go elsewhere if this does not get resolved appropriately.

Thanks everyone. I heard back at the end of the day today and they had another patient with the same issue today. That patient was saying exactly what I did, they looked into it and called me. They apologized and explained I was right about insurance and to get started on all the other appts. In the meantime, I started looking into other doctors. I spoke to one who was extremely helpful and now I'm at a loss of what to do. I really like Dr. Peters and felt very comfortable there, until the issue with the insurance question.

Amy, I'm the one who emailed you after the last info. session last month. If you get a chance, I was hoping we could talk more.