Medical Insurance Mess
I spoke with a person at Genomics, the company that offers the Oncotype-DX test. They had to talk to me about issues of insurance cover and all that. She was saying that Health Net, which is now my secondary insurance, has paid for the test six times in the last 120 days. That means that there is a chance they will pay for the test for me. She said, "I see that you are almost at your $4,500 out-of-pocket calendar year maximum already, which means might pay 100%."
I'm almost at the $4,500 out-of-pocket maximum? I haven't yet received the bills, so I don't yet know what I owe. Yikes. I also asked why she was only mentioning my secondary insurance, not my new primary insurance. She explained that UCSF had only provided information on Health Net.
Uh-oh.
I called the billing department at UCSF and it turns out they haven't been billing UnitedHealthCare. They didn't think it was my primary insurance. I've given the information out about eight times since the beginning of April and yet somehow, it's never made its way to the billing department. So, now they have to re-do the insurance billing and hopefully, in a month, I'll get new statements.
Of course, now I get the statement from Health Net for the core needle biopsy. I had that on March 31st, a day before my UnitedHealthCare coverage started, so I'm subject to Health Net's coverage rules. As it turns out, the core needle biopsy is listed under surgery or something and it runs almost $10,000. My share is $2,700. No wonder Genomics said I'm almost at my $4,500 out-of-pocket maximum...that was just one day. Eeek.
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