This is a public-service warning sort of post. I don’t want anyone else to make the same mistake I did.

A few years ago, I switched from my nice co-pay insurance plan to a high deductible plan — one that only pays for my meds and doctor visits once I’ve spent more than my deductible. This move was purely economic; I was turning 35 and the insurance company was going to increase my premiums by an absurd amount. I figured it was cheaper to pay out of pocket for the odd doctor’s visit and prescriptions rather than pay $80 more each month for the insurance. I’d say that’s been a good decision, but there was one drawback I only recently discovered.

Typically, the insurance company negotiates discounts with doctors — so their patients get a reduction on the cost of any visits or procedures. What I didn’t realize was that the doctor’s offices weren’t considering that discount when they told me what I owed them. Foolishly, I figured they knew what they were doing when they told me how much to pay.

A few months ago, I visited my sinus doctor and when I checked out, the assistant looked at my papers and said, “Hmm… I guess I’ll charge you $50 today.” I thought that seemed too low (a sad commentary on how quickly I got used to high charges for office visits!), so I was paying attention when I got my statement from the insurance company. I was shocked to look at the statement and see that, not only didn’t I owe them more, I had overpaid by $11.25.

Not knowing how the credit-issuing process worked, I called the office and explained what had happened. The receptionist said she would have accounting send me a check for my credit, and I was pleased.

Then I got the check — and it was almost 4 times the $11.25 I was expecting. After being initially flummoxed, I did some research and realized what had happened: they had overcharged me for two earlier visits as well. I had credits on their books going back over 3 years. If I hadn’t called, I’d have never gotten my money.

Spurred by the discovery, I did some more research and found one other doctor who had overcharged me. I sent a letter to their office with documentation and got back a check for $36.

So I got back nearly $80 of my money that my doctors had. Imagine if I went to the doctor more often!

Let this serve as a warning to others. Those statements the insurance company sends you really ought to be reviewed — and no one’s going to return your money unless you ask.


Comments are closed.