I may have to delay surgery

I am having problems with the Insurance Company and the Doctor's Office.  The tax i.d. the doctor's office is filing under, my insurance says my doctor is not under that i.d. but is under another one.  So my insurance is saying he is out of network.  They will only pay 65%.  The insurance company gave the office manager of the doctor's office a number to call and have him put under the correct i.d number.  (The one of the center)  Well the office manager told her employee to tell us that she tried and the insurance company would not put the doctor under the correct i.d.  Now of course the office manager will not even give us the courtesy of speaking to us on the phone.  The insurance company said this was an easy fix.  The office manager refuses to let my bill be filed under the other insurance i.d.  My husband says if they do not pay in network we can not afford the surgery.  Why should I have to pay out of network when he does have a contract with my insurance.  I will be on the phone again tomorrow to try and get this straightened out.    Please send prayers out for me.  Yes, I know a lot of people pay cash for the entire procedure.  But my insurance pays 85% in network! I'll have my fightn' gloves on tomorrow.

Wow Elizabeth, that really sux. Hopefully it gets sorted out soon. Sending hugs out to ya. xoxoxo

Elizabeth,

Don't give up or give in.  Call the California State Department of Managed Health Care if need be, they do have a hotline for this type of thing.

Hugs,
Barb

Hi Elizabeth!

That stinks about the idiot office manager.  To get the problem settled, I suggest that you go to the office (if it is not far away) and sit in the lobby until the issue is resolved.  Make sure they know you are still there.  Check in with the receptionist at least every 10 minutes or so.  If the office manager won't talk to you, ask to speak with the doctor.  Be firm and persistent, but above all esle, be nice no matter what.

You will get your number changed, I will almost guarantee it.

Good Luck!!!!!!!

jillie

Thank you for all of your advice.  The doctor's office is about 1 1/2 hours away but I will go down there if I need to.  I will also call the place Barb told me about I am not going to give up.   (Think the Rockey song in your head!)

My husband told me not to be so hard on the office manager.  He said she could have been very busy and told the other employee what to say to help us.  (AM I BAD!)  He is the locgical one in the family!

I agree with the other ladies don't give up. Sometimes they are just a little lazy and you have to give them a kick in the butt! lol! Good luck tomorrow and I hope all gets starightened out!

My husband who is very good at pulling me back in when I get to upset about things.  Explained to me that even though my doctor has a tax i.d., it was probaby before he formed a new corporation with his current partner and he legally can not bill under that i.d.  I am really thankful for my husband he is so calm.  I still haven't gotten anywhere yet.  I am waiting for a call back from the insurance co. 

That stinks Elizabeth but where there's a will there's a way.  Your hubby may be right about the numbers.  Have you asked the insurance company to provide a list of their innetwork Drs and see if you your doctor would transfer your case??  Just thinking outside the box?  Don't worry I know it will get worked out.
Debbie