I’m so sick of dealing with the insurance companies!

So I have been having a lot of diagnostic tests lately for multiple health issues and maintenance. I had called the insurance company just to double check about by endoscopy and Colonoscopy. They told me yeah your doctor is Tier one but the ambulatory center is not? So this didn’t sound right to me. I was on the phone for hours and they said that’s what it is. So I’m starting to panic using the insurance website and I can’t find anymore information. Then I call the clinic and they told me everything has been approved months ago. But the clinic doesn’t know if it’s covered tier one or tier two or the dreaded “In network” which is the most expensive. I have PPO so it’s not an HMO thing. Then so call the insurance company again and they tell me yeah it’s tier one care! So a completely different answer from a different CSR. So I gave up and just went in for the procedures because I wanted the endoscopy done while having the colonoscopy at the same time. Well I got the pre insurance price back and it’s $12,000 before discounts insurance and copay. So now I’m fretting about what my actual copay will be? The website is trash and outdated and this is a major insurance company! What other businesses can just leave you in the dark about your out of pocket costs? I’m getting another diagnostic test on Monday and it’s pretty minor. The clinic I usually use doesn’t do the procedure there and they want me to go to a satellite office. The insurance company says they can’t find the office so it’s not in network. So I call the clinic and they tell me it’s the same tax ID so it shouldn’t make a difference?!? Still I’m insecure about what my out of pocket price is?!? And it’s a big difference between Tier one tier 2 and standard care. Tier one and tier two difference is a $700 out of pocket per year than 15% after that and tier 2 is like $1400 per year and 25% after that until $4000?!? Forget “standard care it’s like 50% out of pocket until $10,000! It’s so damn confusing! Are they doing this on purpose? Even if I find a tier 1 outside my clinic my doctor at the clinic can’t refer outside the clinic because it’s not contracted and of course it’s more difficult for him to get the results anyway from another clinic! I’m in Chicago so there are Tons of providers so that’s not the issue! The issue is it’s impossible to tell if their tier one or not and I get different answers from different CSRs at the insurance company! Therefore I don’t really know what my out of pocket is?!? Who would purposely go to any provider other than tier one unless they had some rare disease? I’m in the 3rd biggest city in the United States! I already have anxiety issues if you haven’t noticed and now I’m going through procedures not knowing what I’ll be paying for weeks until insurance reimbursement to the providers?!? Is this normal? Does this make sense to anyone?

https://ift.tt/YhyI5qv Submitted September 17, 2023 at 05:08AM by PissedCaucasian https://ift.tt/jiogDUz