I have been experiencing issues with my shoulder for a few months. Saw my PCP and she suggested for me to see a specialist. With my insurance, I have to have a referral, so my doctor commenced that process which took about a week.
Once I receive the referral, it was for INOV8. I was relived because I was in a lot of pain, especially at nights which made it very difficult for me to sleep. I received communication from the office and was asked a specific question about my insurance, which the answer was Yes! I was then told that they did not accept my type of insurance.
I was confused because my insurance company already vetted them, and approved the referral. I reached back out to them again, and the young lady that answered the phone was not very nice. It seemed as if I called her personal number and she was annoyed that I was calling. I told her my concern, and she placed me on hold to speak with someone in the billing department. She came back on the phone and informed me that I am considered out of network, which means I will have to pay everything out of pocket. I said to her, this doesn't make any sense at all. I asked, why would my insurance company send me here, if I am considered out of network? She did not have an answer for me.
Shortly thereafter I received a text message from a lady by the name of Monica de la Cruz stating the following: "Mr. XXX, I am in the billing department so I know we are not on any Exchange plans. If you would like to schedule an appointment that is fine. We will collect in full and IF insurance pays the claim we will be glad to refund your payment. We will have you sign a financial form informing you of this as well. Thank you!"
Needless to say I call my insurance company. I told them what was told to me and they too were confused as to why INOV8 was telling me I am considered out of network because they do not accept my insurance. The person I spoke with at the insurance company said they will reach out to them.
A few days later, I received another message from INOV8, and it was from Monica again. Her message reads as thus: "Good afternoon Mr. XXX, first I would like to send my sincere apologies to you. I just got off the phone with BCBS and we are in network with your insurance. "We were not aware of this." If you would like to come in and see Dr. Vansadia you are more than welcome too. If surgery is required Memorial Hermann is not in network. Dr. Vansadia does go to INOV8 Surgical which is an Ambulatory Surgical Center next door (no affiliation). All has been confirmed with BCBS ref number....."
Trust me when I say I am MORE than ANGRY! How can you, Monica tell me "you're in the billing department, so you know you are not on any exchange," then come back and say, "we were not aware of this!" Wouldn't a person in billing know what type of insurance they accept or not? And because I was adamant about this, why would you not pick up the phone can call my insurance company? Also, why would ANYONE pay out of pocket when their insurance is covering EVERYTHING at 100%? Who does that? Can you make that make sense to me, because I am not about to pay you anything in full, wait for my insurance to pay you, then wait for my funds to be refunded. That's NOT how that works Monica/INOV8!!!
This situation was handled very sloppy and was very unprofessional. If this is the way you guys handled me when it came to my insurance, I can only imagine if I needed to have a procedure done what would happen. You must do better because this is unacceptable. Needless to say, I spoke with my PCP and have them send BCBS another referral and I am now going to another doctor. At this point, I do not trust anything INOV8 tells me because you came into this situation with uncleaned hands. read more