Thursday, April 8, 2010


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.


Lisa said...

so totally offside as far as i'm concerned.... she should have told you the "insurance" rate upfront knowing that you were claiming it. not cool...