Author Topic: Double-Billing and reimbursmenet  (Read 200 times)

olicoffeesoul

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Double-Billing and reimbursmenet
« on: July 09, 2022, 05:22:28 PM »
 Hello Everyone,
I need your help to understand some thing in billing. I am going through IVF treatment and my insurance has a very limited coverage in that department. I think it was around 5k lifetime and I used it for diagnostics. In March I started my second IVF cycle and since my insurance have very limited fertility coverage, I had to pay for entire cycle out of pocket. I signed an agreement with the hospital that they are not going to bill my insurance because it doesnít cover fertility treatments and I am self-paying. A week later, after I completed a treatment, the hospital sent me a bill ($17.000) for an entire cycle (which I have already paid in full.) So I called the financial team and we have resolved the issue. Now I am preparing for embryo transfer which scheduled for July. The financial team sent me an estimate for an embryo transfer. But a few days ago I discovered that back in March the hospital charged my insurance for two ultrasounds and a blood work, total of $1240, and it is all after I have already paid them in full and signed an agreement that they are not going to bill my insurance because it won't cover anything. So, I brought it up to a financial team, hoping that they will apply this amount ($1240) to my frozen transfer in July, since they double-billed me, but to my surprise they said they have already reimbursed my insurance. :o Is it even a thing? Do hospitals really reimburse insurances or someone doesnít tell me the truth because they donít want to get in trouble for double-billing?! And then again, why the hospital reimburses my insurance and not me? Isnít it why we have medical insurance in a first place, so it covers certain medical procedures?! To be noted, same exact thing happened to me last year during my first IVF cycle. I paid out of pocket, then they billed my insurance for ultrasounds and blood work up to 7K. But when I brought it up to them, they applied this credit for my frozen embryo transfer, which needles to say failed. So why this time they reimbursing insurance? Can the hospital chose who's money they take? To be noted, the hospital charges health insurance higher rate than they charge self-pay patients. How should I deal with this situation? Should I let it slide or should I speak with a supervisor?

Need an advice. Any info will be helpful and much appreciated!

Thank you!
« Last Edit: July 09, 2022, 05:33:41 PM by olicoffeesoul »

Medical Billing Forum

Double-Billing and reimbursmenet
« on: July 09, 2022, 05:22:28 PM »