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dealing with insurance companies

Posted by Nancy N on 4/18/01 at 19:50 (045022)

This is a little off-topic from feet, but I really need to vent about my vision insurance, so please bear with me.

I have this Vision Service Plan (I think that's what it's called; it's abbreviated VSP) that pays for me to have my eyes examined once a year, and to get new glasses or contacts once a year. I went to my old eye doctor last April for an exam and used my coverage then. In September, I decided to switch doctors and went to see an optometrist here in NJ (my old doctor was in PA) because I was worried about dry eyes. Somehow, this never got to her and I ended up with a regular exam and contact lens fitting. I was worried about whether or not all this was covered and was told repeatedly that their information showed that I was covered.

Well, naturally, about a month later, I got a bill saying that I wasn't covered because I'd used my benefit in April. I managed to work this out with them, because I had asked at least three or four times while I was there if they were sure about my coverage.

So now it's April, and I need new contacts, so I thought I'd go back and get re-fitted because I'm not sure that everything was right the last time, and I should be able to use my plan now. You see what's coming here, right? I made the appointment yesterday, but got a call today saying that they're having trouble with the VSP and I'll have to pay out-of-pocket next month because I'd used my benefit in September!!! Well, excuuuuuse me, but I didn't write a check to them because everything was covered! DUH!! How can I have used the benefit in September if I had to pay out-of-pocket?? Are they so incapable of checking their records?

(Can you tell that I really wish I could go yell my lungs out right now over this??)

I guess tomorrow I get to make this really pleasant phone call to the eye doctor's office from work, which will really be fun. Has anyone had any experience dealing with VSP? Am I in for a really nasty ride here, or should this be a simple thing to fix?

Thanks for listening.

Re: dealing with insurance companies

Richard, C.Ped on 4/19/01 at 06:19 (045057)

Hi Nancy,
Trust me, I feel your pain. In our office, I deal with insurance companies all the time. I have learned that you always have to write down names, titles, date and time you spoke with anyone concerning reimbursment. This includes the eye people as well.

You have to stay on some of these guys. Try to find the check you sent in as well as all the paperwork that was done. Tell them (don't ask) that you will fax everything to them so they can see for themselves. Of course, use a magic marker to cross out your routing and account numbers.

I have found that with most larger insurance companies, you get a different person every time you call.

I am on my wife's insurance. When I was trying to get my eye stuff covered, I called the '800' number to get the necessary info for filing. I was transfered about three times before I spoke with the correct person. I was lucky, she was more than willing to give me all the proper information as to address as well as what specific group number to write on the receipt. Oh yeah, always keep copies.

Stay on them.
Richard

Re: dealing with insurance companies

Richard, C.Ped on 4/19/01 at 06:19 (045057)

Hi Nancy,
Trust me, I feel your pain. In our office, I deal with insurance companies all the time. I have learned that you always have to write down names, titles, date and time you spoke with anyone concerning reimbursment. This includes the eye people as well.

You have to stay on some of these guys. Try to find the check you sent in as well as all the paperwork that was done. Tell them (don't ask) that you will fax everything to them so they can see for themselves. Of course, use a magic marker to cross out your routing and account numbers.

I have found that with most larger insurance companies, you get a different person every time you call.

I am on my wife's insurance. When I was trying to get my eye stuff covered, I called the '800' number to get the necessary info for filing. I was transfered about three times before I spoke with the correct person. I was lucky, she was more than willing to give me all the proper information as to address as well as what specific group number to write on the receipt. Oh yeah, always keep copies.

Stay on them.
Richard