medicare/vaccinations

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Old 09-16-15, 01:06 PM
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medicare/vaccinations

This is part warning and part rant.

I have medicare with blue cross supplement. I don't know if this only pertains to my plan or if it's across the board but back in july when I went to my general practitioner, along with blood tests they insisted that I get the shingles vaccine. Because the vaccine was done at the doctor's office instead of a participating pharmacy - I got billed $286 for it

I spent 2 hrs [on/off] with BC customer service [those gals are great!] trying to understand my bill from the provider along with the insurance monthly statement that says what I can be charged. I don't know how the health provider [big company includes hosp and most of my doctors] does their book keeping but they routinely charge me for stuff that is supposed to be covered in my plan and co pays that don't exist. I had a $70 credit from where they overcharged me previously, that along with the copays I paid but wasn't credited with got the bill down to $141. The customer service gal says she'll work on figuring out how I can get reimbursed for part/all of the $286 thru my part D coverage

some days you just want to go wring someone's neck or blow up their office
 
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Old 09-16-15, 01:51 PM
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We had a thread running a while back on similar stuff and I mentioned my go around with Tricare coverage. With Tricare, they specifically say the shingles vac MUST be given in a doctor's office, a 180 from your experience. My doc said the vaccine costs him something like $180 per does, so it's apparently a massively expensive vaccine. Doesn't really make sense to me, but that's the way drugs go sometimes.
 
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Old 09-16-15, 01:52 PM
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I can see why you could be disturbed . . . . that's the same Shingles Vaccine that my Wife paid $6.60 for when it was administered at Walmart !

I got it at the VA myself.
 
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Old 09-16-15, 02:03 PM
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What really irks me is I initially refused the vaccine since I've never had chickenpox so I shouldn't need it but the doc persisted and talked me into it

I guess if the regional health system cheats 1000 folks out of $100 each year that pays some executive's salary. It would almost be easier to pay them than to fight for what they overcharge -- but I hate being cheated!!
 
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Old 09-16-15, 02:38 PM
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On my list is a future discussion with my primary care and medicare et al on how to track all billing. How can I know whether something should have been covered when a bill comes referencing a date almost a year ago and there is no human description as to what the bill is for, just numbers. I suspect things like what you experienced, they just send out the bill and let most pay. Those who complain, they make some adjustment.

Fortunately my merry-go-round has slowed so my discussions will have to wait, but I don't trust them.

Bud
 
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Old 09-17-15, 04:23 AM
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Mark:

"I don't know how the health provider [big company includes hosp and most of my doctors] does their book keeping but they routinely charge me for stuff that is supposed to be covered in my plan and co pays that don't exist."
Once back a few years ago experienced same situation... Solution suggested by insurance rep was they needed to send there rep to reinstruct their medical providers. Reason she claimed made sense. Employee turnover and insurance confusions plus changes insurance makes to their plan.

Suggest to insurance company to due the same. Send their rep to update, train and/or retrain current medical office billing department staff. I have no further problems as a result...

 
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