rev:text
| - The day I had a procedure last December (12/10/2014) the gals at the check in desk informed me that my insurance may not pay for the procedure codes and that I may be responsible for over $4,000. I stopped my check in at that time and called my insurance company to verify if this was true. They assured me they would pay and my policy does cover this procedure.
I continued the check in process, but Gateway Surgery Center insisted I pay Aetna's contracted amount up front. When I baulked, they informed me this is their process and they would refund me the $396 I paid today as soon as they received payment from Aetna.
This is unusual as you are usually billed if or when the insurance has issued an explanation of benefits and paid their amount. I've worked in the medical billing industry and have never seen this practiced. Since my appointment was scheduled at this time though, I was told to either "pay up or cancel the procedure." With that choice, I paid up and had the procedure.
I discovered back in September 2015 that my insurance paid the bill in full back in January 2015 (8 months ago) and that Gateway Surgery Center owes me $396. They didn't automatically issue me the refund and I never received any billings from them. In fact, I called them in September and they told me, "Oops, I don't know what happened here," and they'd process the refund; I should receive the check within 3 weeks. It is now November 20, 2015 and I still don't have a refund. I've made numerous follow up calls and still haven't received my refund.
Bottom Line: 1) Their business practices are unethical. 2) They should not be billing insured patients up front, but should wait until the insurance has paid. 3) They do not issue refunds if both you and your insurance have paid. Check your EOB from your insurance company and see if they owe you a refund.
|