Well this is fun (not).
For the first time ever I was finally sent 2 bills from "Biotel Heart". Both for dates of service in 2022 which BC/BS denied because of "wrong procedure codes".
So instead now they are billing me DIRECT without actual insurance contract negotiated rates. Their statements are for $880 with an $800 "discount" saying I owe $80 for each. Oddly, for the few of their submissions over the past 3 years which DID get approved by BC/BS the amounts I was responsible for was $12 (and after my BC/BS deductible had been hit the amount was only $1 and something) - and for those dates of service (which go back to 2021) they have yet to bill me.
The bills I now received clearly state to contact your insurance company with insurance related questions before calling us so that is what I did. Person I spoke with at BC/BS basically said that they cannot bill me like this and need to get proper clearance/go through BC/BS, submit with the proper codes, then bill me the adjusted amounts.
He setup a 3-way conference call to Biotel with him on the line so we could all discuss. But Biotel Heart is so overwhelmed (or short staffed?) that we cannot get through. Tried this twice already. First time their system said our wait time was 40 minutes. After about 10-20 minutes we got kicked out of their hold queue and forced into a "leave a voice message" type of thing. Since that would not work for our conference call we decided to reconvene and try again the next week (on my next day off).
Similar thing happened again. On hold 10-15 minutes but kicked out to voice message system again.
BC/BS rep is supposed to try to call them on his own in the meantime then get back with me next week.
I thought I posted an update to this but it appears to be gone? Or reported (if so I assume by someone who works at Biotel Heart who doesn't like their company looking as bad as they are). Or I am losing my mind.
If my post was "reported" I would like to know why though.. This is ridiculous. If this post disappears/gets "reported" then I'm done here. So if you want me gone, go ahead....
UPDATE: As best I can recall now.
We were able to get through to Biotel the following week. Had a 3 way conference call. Biotel rep vs. BC/BS rep. Very long story. Short story is that the Biotel was told that they need to resubmit their bills to BC/BS and use the right procedure codes, and if they need help from BC/BS on that then they have to call that appropriate dept (not the territory of the customer rep who told them this). I gave the Biotel rep the # she needed to call & she promised to escalate this to a Supervisor and someone would get back to me within 5 business days as to what the status was.
It's now like 3 weeks (?) later. Have heard nothing. Other than just got another BC/BS EOB for a Biotel charge this time for last month or two, which was denied for wrong procedure codes yet again. How do they even stay in business?
