I check my benefits statement (relatively new insurance from ANJ), and it clearly states they cover blood work diagnostics 100% as long as they're ordered by my doctor.
I call insurance company... nobody there until Monday.
Forgot to call yesterday. Call this morning.
Call goes right through to Bubbly Brianna (BB) at member services:
Me: "I got a bill from the lab that did blood work ordered by my doctor that you guys denied"
BB: "Please give me a list of all your personal information so I can find you in my computer and confirm that you are indeed who you say you are"... "oh and give me the date of service".
Me: "rattle off list of personal information to prove that I am me" and "oh 2/13/09 is date of service"
BB: "We don't have any claims submitted for you after January"
Me: "um.. would you if you denied the claim"
BB: "Yes, and we'd have a claim rejection code that would tell me why we denied it, so call the lab and tell them to send it to the right insurance company."
Call Lab Bill Services
Wait on hold for 20 minutes (yeah, really happy about this)
Finally reach Smoking all my life Sue (SamlS)
Me: "I received a bill from you that said that my insurance company denied the claim, I called the insurance company as instructed on the bill and they have no record of the claim"
SamlS: "what's the claim #"
Me: "claim #"
SamlS: "you have Big Insurance Company plan right?"
Samls: "oh yes, we submitted that claim to them today for $29 less than the bill I received
Me: "That's weird because the bill I received says you sumitted the claim a few weeks ago and it was denied oh and that it's $29 more than the quoted amount
SamlS: " Oh yeah, I see that we did send it a few weeks ago and they paid $29, so we submitted it again today, so don't worry about it, I'm sure they'll pay the rest"
Me: "um.. you're sure? Shouldn't you check to see you have the right member # or spelled my name correctly"
SamlS:" I guess, go ahead and tell me"
Me: carefully read off "member #" and spell "my name"
SamlS: "yeap we have it, don't worry about it, they'll pay the rest"
So.... how many of you think I'll be making at least two more phone calls in about 2 weeks when my insurance maybe makes another $29 payment (less than 1/4 of the bill!)??