I probably shouldn't be complaining since we're fortunate enough to have coverage for this, but I'm so frustrated!
I have $1000 worth of acupuncture coverage through my insurance, so I've been going to acupuncture since last July, but I switched acupuncturists in January of this year. With my prior acupuncturist, I always self-billed the insurance company myself -- paid cash to the acu and then got reimbursed by the insurance company. A slight pain in the ass, but no big deal.
Anyway, with my new acupuncturist, I was going to do the usual self-billing. Her rate is $85/session, so very reasonable, but she told me that she had a great insurance-billing company and that they could do the billing, no problem. I jumped at this because it would save me some paperwork. However, she neglected to tell me that the insurance rate was way more than $85!
I didn't find this out until the insurance company screwed up and sent me the reimbursement checks which should have gone to her. I looked at the claims and each session was billed at $270/session!! I emailed her and basically said WTF?! After 4 sessions my $1000 coverage was all used up.
She emailed back and said that her billing company had screwed up and they should've billed $170/session because that is her insurance rate and her cash rate is $85. Had I known that her insurance rate was 2X her cash rate, I would've just done the billing myself!
All of this seems a bit fishy. Can a doctor bill the insurance 2X as much as the cash rate? How the hell did she initially bill the insurance company $270/session? Why didn't she disclose how much she was billing the insurance when she knew that my coverage only covered up to $1000?
I'm pretty pissed about all this. I tracked all the sessions and the payments and made sure that I didn't exceed the $1000 limit. Right now, I'm refusing to pay anything else out-of-pocket. I'll give her what the insurance company paid me, but that's it...nothing more.
My sons are 6!
4 months ago