Health insurance question

[bettymae1121]

Not quite sure what, if anything, I should do so I thought I'd ask the Dis "experts"!

DH had an accident back in mid July, was working on the house and shot a nail through his finger with a nail gun . Took him to the ER, hand surgeon took out the nail, he had a few follow up visits at the hand surgeons office and he's healing nicely now.

So, I've been logging in to my health insurance website to make sure the insurance claims are being paid...unfortunetely they haven't yet. It shows only the hand surgeon as submitting his bill, the hospital doesn't show that they've submitted at all yet. The surgeon's claim is listed as "not paid" but it doesn't say "denied" either. Neither the hospital nor the surgeon have mailed us bills, and I've received no benifits explaination from the insurance, either.

Should I call the hospital and ask if they've submitted yet? Should I call BCBS and ask what's going on? Or should I just leave it alone? It's been two months and I'm just worried the surgeon and hospital will bill us because they haven't been paid by BCBS yet. Our insurance coverage through my employer is excellent, there is no reason it should be denied. Then again if the hospital hasn't submitted yet, then it's there own fault. BCBS can't pay if they don't submit.

Anyway, should I follow up or just keep waiting?

 

[golfgal]

I wouldn't worry about it until you get a bill from the dr or the hospital. Insurance billing is just slow. I just got a bill about 3 weeks ago for something that happened in the beginning of May.

 

[dawson5]

I wouldn't worry yet but would keep an eye on it. I went years ago to an urgent care center, thought everything was taken care of and didn't follow up. I was billed like three years later. I forwarded it to the insurance we had at the time and they denied it because it was beyond a certain amount of time (I think two years).

My hubby went in in January for a stent, I don't think we started seeing break-downs of what it cost until late March, not bills just what they were billing the insurance for. I don't think we received our first actual bill (doctor billed first for us) until a few weeks after that. Final bill for the hospital showed up in early to mid-May.

 

[bettymae1121]

Thanks, both of you. In the past the claims showed up on my insurance website within 30 days, so I was getting a bit worried about it. I'll just keep an eye on things.

 

[KLAIT]

I also would not worry about it yet. It could be that there was incomplete pricing or was billed incorrectly and the insurance company is requesting additional info. I handle benefits here at work and see this happen often. BUT, keep an eye on it.

 

[cepmom]

I also would just wait and see. I know BCBS also will follow up and certain things to see if it was auto or work related so that may be what's taking so long. They usually send a form to you to call and let them know the nature of the ER visit. We got one from when I had to take DD to the ER for stiches. After I called them about it, the claim was paid.

 

[disfan07]

We also have Blue Cross. We get bills staggered like crazy from them. I had surgery 12 weeks ago. We didnt see the first bill until 6 weeks after surgery and that was just to let us know that they had submitted it. We got 6 of those types of bills over a 3 weeks period. We still do not knmow if they paid eveyrthing in full (they are supposed...I was covered 100% at that point so we shouldnt be paying anything).

When I had my EP study last october, we didnt get anything telling us it was paid until about 4 months afterwards.

We find them to be very very slow with claims.