Insurance Billing Errors or are they?

A few weeks ago, I went to the dentist for a routine cleaning and check-up. I try to take care of my teeth as much as possible to avoid pain and anguish at the dentist. No problems were found at my visit. I was in and out the door in under 30 minutes! Not too bad. My insurance pays the entire dentist bill, so I didn’t even need to worry about paying anything.

Last week, I received the billing statement from the insurance company. It had on there the following: Periodic oral evaluation, prophylaxis – adult, topical application of fluoride – adult, and bitewings – two films. What? I didn’t have any x-rays done.

I e-mailed the insurance company and explained the problem to them. Their response was less than enthusiastic about looking into the problem. I gave them all of the information I thought they needed, but, of course, they requested more information, which I sent to them in a second e-mail stating that I did want them to look into the problem.

Here is their response I received from them yesterday.

“Please be advised that Dr. ******’s office did submit a claim for the below referenced x-rays and have been paid for them. This does affect your account as it has reduced your available benefit by $28. We advise that you contact Dr. ******'s office and request that they return the $28 to **** [us] or allow you to have the x-rays done.”

Again I say, What? I have to call and complain to the dentist that my insurance company was overcharged! Don’t forget this is the dentist, you know, the guy who shoves sharp objects into your mouth, gives you shots in the mouth, and has a wide variety of other torturous tools that can be used. Or I could just go and have the x-rays done to avoid the overcharge! I only pay $3.51 per month for my dental coverage. Why would I want to complain over $28 that I don’t even have to pay for! But someone has to pay, right?

As I reviewed the information more thoroughly, I found out that our insurance company is simply a billing company. They charge my employer about $2000 per month to handle all of the billing claims. The insurance company pays the bills to the dentists and then bills my employer for those claims that were paid. Confused yet? Essentially, my employer pays for all dental costs plus a large fee to the “insurance” company. Therefore, the “insurance” company has no incentive to look into billing errors.

No wonder it is estimated that 85% of medical bills have errors on them. No one is held accountable for the contents. So who is really paying for these errors? In my case, the state and local taxpayers. In the case of corporations, the consumer will be paying the bill in the form of higher costs on the product or service the corporation is selling.

So the moral of the story is to pay attention to your medical bills!

Driving Aggravation

Most people here in Rural Pennsylvania must drive a motorized vehicle to get to their destination. There aren’t any public transportation systems to utilize. After several years of driving and observing other people drive, I have come to some conclusions.

Someone is usually going to be driving faster than you and will either pass you or will be tailgating you. Solution: pull over and let the other driver pass you if it is safe.

Someone is usually going to be driving slower than you. Solution: don’t tailgate and pass the driver only when it is legal and safe.

You will eventually catch up to most of the cars that go speeding by you.

If you drive 30 miles to your destination, it will take you 30 minutes if you are driving 60 m.p.h. or 28 minutes driving 65 m.p.h. or 33 minutes driving 55 m.p.h. According to the National Safety Council's Defensive Driving Course for Professional Truck Drivers the average stopping distance for a passenger car is 225 feet at 55 m.p.h. and 316 at 65 m.p.h. That is a difference of 91 feet.

I always find it amusing when a police officer is sitting with radar, everyone slows down, usually below the speed limit. I never need to worry and rarely even look at my speed when passing a police car. I try to obey the speed limit all the time for several reasons.

It’s the law. Believe it or not, there is a reason for speed limits. Obey them.

I don’t have to worry about getting a speeding ticket or worry about getting pulled over for speeding.

I can’t imagine the emotional pain of wrecking and injuring or killing someone, but to know that I was speeding and disobeying the law would make the pain much worse, plus the ramifications of possible jail time.

If you are a habitual speeder and are having trouble getting to places on time, then you need to wake up in the morning and leave earlier. As shown above, you are really only “saving” a few minutes, but you are putting more lives at risk. Also, please don’t talk on the phone, put on makeup, eat, read the news, or anything else that distracts you from your main responsibility of driving.

Comments are always welcome.