GRRRR - Insurance Billing & Twins

ARGH! I'm SOOO tired of getting double, triple, and quadruple billed for things from my pediatrician & insurance company b/c of the girls. Apparently its not possible to correctly bill when you have two children with the same birthdate receiving similar or identical services - and things keep getting rejected b/c one child shouldn't get two sets of well-baby shots. And heaven forbid they get DIFFERENT things done!

And then I have to discuss it all w/customer service reps from both the doctor office and the insurance company, each saying the other is at fault...grrrrrr...

 

I know exactly what you mean! It sure stinks! You'd think they'd red flag the paperwork or something to say TWINS-get a clue people!!!
We had such a difficult time with our pharmacy when our boys got eye infections- we got drops for one and they wouldn't approve a second set for the 2nd baby as we just got drops the day before! We had to use Jack's medication on Paul until day 5 when it was allowed to get a refill! The pharmacy even saw both babies but said it was a glitch in their system they could not override- we changed pharmacies. We'll probably end up with the same thing if unfortunately they ever get it again- but it just made us so upset. And it isn't easy to have to keep going back to the dr. or pharmacy with 2 sick babies!!
Sorry to go on and on- but know you are not alone!!!
Lanie

 

I suppose I should be happy that it's a minor thing, but what I can't figure out is how our insurance company can approve hundreds of thousands of dollars of NICU bills times two without a problem, yet they can't approve two fluoride prescriptions for six bucks each!!!! Every time, the pharmacy has to call the insurance company, get through to talk to a real human, and explain that this is not a 'refill too soon' but rather two separate prescriptions. Doesn't the insurance company get tired of this, too? I mean, eventually we all get it sorted out so they have to pay in the end, right? So isn't it just costing them more of a hassle, just like it's costing us and our providers, to not just figure out how to work the stupid computer system so it recognizes that it's possible for two children in the same family to be born with the same birthdate?!?! Right there with ya!!

 

it has happened to me also. I also used to work in dental insurance billing.

Here are a few tips on getting claims paid: 1. You may ask your doctor to do paper filing instead of electronic submission. If they won't do it, then ask them to please give you a paper print out of the insurance claim that they would send electronically. Then you can mail a photocopy of the insurance bill yourself. Also viewing the paper insurance form will allow you to verify that they have each child's name and birthdate correct.

2. Another thing when contacting insurance companies, be sure to write down the date, time, CSR's name that you spoke with. In many states it is illegal for the ins to NOT pay by 30 days. You can talk to a supervisor of the ins company, and let them know you aren't happy with their payment turn-around time and that you can /will report it to the insurance commissioner for your state. We have to remember that ins companies are supposed to help us, they are our employees technically.

3. You can also speak with the HR person at your/DH office who is responsible for choosing health insurance and let them know you are having problems with getting claims paid properly and in a timely fashion. Perhaps the employer can put the heat on the insurance company.

4. One final suggestion is to call the ins company on the date of the appointment and ask them to "flag" your account that you're taking your twins to the doctor and you don't want the claim to get messed up again. They can flag it so that you have to be "hand processed", as opposed to the computer automatically processing the electronically submitted claim.

Hope these tips help someone.

 

I have seen many people here complain of the same thing. I think it is just a "safety" device so try to eliminate dup billing. just be patient, it does get better as they get older.

 

We were going round and round with the insurance company for about 18 months after the bills started coming in for their delivery, NICU time. They paid for/approved all of Nick's claims, but denied Joe's. You'd think that would be an easy enough oversight to solve over the phone "Oh, they're twins? Well, let me just make this adjustment and ressubmit the claim." Right. Only in a fantasy world.
Every time i called to talk to someone I got a different answer about their procedures. I should go dig up my call log notes (about 40+ calls over 1.5 years). I swear it would make for a most hilarious stand-up routine.

 

One benefit of mine having different B-days :laughing: Though that invites a whole other list of problems ("what do you mean they were born a day apart?" )!!!

 

I have thankfully only had this problem once. I called both companies and told them....and I left it alone and it eventually resolved itself...go figure.

I thought the insurance/doctors filed claims by insurance id or social security number. You would think with different names that the pharmacy (especially since they can see them) would be able to fix their system and input 2 seperate people. There should be no reason why they should be getting this wrong. I have (thankfully) never had a problem with a pharmacy denying the claim....that seems to be very dangerous. I would have called corporate.

 

Yep its crazy ... mine kept denying the second because they thought it was submitted twice and it took 6 mionths or so to get them to realize there were two not one iwth four names lol

 

QUOTE(jennyj @ Jan 29 2008, 08:21 PM) [snapback]596084[/snapback]
Yep its crazy ... mine kept denying the second because they thought it was submitted twice and it took 6 mionths or so to get them to realize there were two not one iwth four names lol



Wow...That's insane!

 

We only had this problem once when papers were filed A and B. Suprizing since A and B are more different than Jazzy and Jessy.

 

one way to eliminate the pharmacy issue is to do what my pedi does - writes a double prescription for one child and I give to both (if they both need it)...it also means only ONE copay...

fortunately we had no issues with insurance billing - perhaps because they're b/g?

 

QUOTE(Slackwater @ Jan 29 2008, 02:19 PM) [snapback]595279[/snapback]
ARGH! I'm SOOO tired of getting double, triple, and quadruple billed for things from my pediatrician & insurance company b/c of the girls. Apparently its not possible to correctly bill when you have two children with the same birthdate receiving similar or identical services - and things keep getting rejected b/c one child shouldn't get two sets of well-baby shots. And heaven forbid they get DIFFERENT things done!

And then I have to discuss it all w/customer service reps from both the doctor office and the insurance company, each saying the other is at fault...grrrrrr...



I feel your pain! It is very annoying.