[SusieQ]

Here is how I am managing the billing challenges: Ask your medical provider and insurance company for statements that includes the timeframe of your entire treatment.

I first look at the insurance companies statement and highlight only the "patient responsibility" charges and match up the date of service with the medical providers statement.

Call the insurance company and let them know what your medical diagnosis is and how you need their help to keep the out of pocket costs down. Ask them to help you figure out if the medical provider is using the correct billing codes. Sometimes, the insurance company does not question the billing codes -- they just data enter the information and the outcome is the outcome.

Our insurance company is suppose to pay 100% on anything related to the labs, scans and treatment of my breast cancer -- less a nominal copay for the Doctor's Visit and Surgical Center Visit. I enlisted the help of my husband, it could be a friend, or relative, as a second pair of eyes to review the statements monthly.

We have found incorrect billing code charges for premeds and hydration infusions. We have also found billing code errors with nurse practitioner "OV" office visits. I was getting billed a "OV" for the 30 second "hello, how are you doing" visits and billed a $30.00 copay. Needless to say, my Onc Billing department took the OV charges off. Sometimes, the medical provider inadvertently inserted an OV code meant for medicine on the insurance billing form and I was billed $30.00. I also found extra copays when I had my first surgery. The insurance company deducted a $100 dollar copay from my Surgeon's bill, the Anesthesiologist's bill and the Surgi Center's Bill. I was only suppose to pay one $100 copay to the Surgi Center. Once I pointed this out, the insurance company sent out checks to my Surgeon and Anesthesiologists.

By the way, I have Aetna NAP - Open Choice plan -- expensive but I am so grateful for it!!! They have been great about paying for some very expensive diagnostic tests including my genetic test and the very inexpensive infusions. This is a lot of data -- I hope it helps!