Out of state?

[keithann]

Hi all,

I'm posting seeing if the world of reddit can help me. My wife is under my insurance, and is pregnant. She has a regular and high risk O.B. We have athem blue cross blue shield. We live in IL and always have.

She just started going to the high risk in January. Somehow, registration completely screwed up and said I lived and work in WI (I never have). So this gets fixed at front desk, she goes through appointments. I think we are good.

Now, we are getting med bills to the correct address, but it says my insurance is out of state. It is not.. never has been. It looks as though it's still paying correct amount, I think? This is our 1st child.

Unrelated, this so called high risk O.B. seems highly unhelpful for our specific reason for being there. We are thinking about ditching the high risk all together.

So I'm wondering if something is screwed up with my insurance, or if it's the medical network. Should we call the OBs and straighten it out there, or call my insurance provider. I find it weird is says out of state but still pays out. If I used incorrect flair I apologize, I wasn't sure which category fit best.

 

[kittin]

@keithann Are you sure you don't have Blue from another state? Many people do and they don't realize it. Does your card say blue of illinois.

All and all I am not sure how much them saying out of state will matter since they have to bill the local blue anywaya

 

[keithann]

@kittin Its strange I've had the same ins company for years, we get a few choices, but we've always gone with that one. Maybe it doesn't matter after all it just seamed really bizarre to me. Could be it switched.

 

[kittin]

@keithann Usally it the state your company is based out of, since the company is buying the insurance. So a Walmart employee in Illinois has blue cross of Arkansas. Is your company corporate or main office out of state? Your card should say what state it is .

 

[keithann]

@kittin It's headquartered in Georgia. I'm not seeing anything on it regarding state, I suppose I could call them and see. It probably means nothing, I just want to make sure things are billed correctly, really. Especially with the high risk registering us as living in WI.

 

[kittin]

@keithann Oh you can also go to website like below look for your 3 letter prefix of your member ID and it will tell you what state it is

http://www.everestvision.com/bcbs-alpha-prefix-list/

 

[keithann]

@kittin And it's... Georgia. Lol

 

[felipetortella]

@keithann Technically since you're in IL and you have Anthem, it's out of state. Anthem is based in... Indiana? I think? It's still a BCBS affiliate so it will still work in Illinois though.

 

[pastorbenok]

@keithann I think you have to call your provider's billing department. I am dealing with a similar issue right now of the provider billing incorrectly. You can call your insurance to double check, but if your insurance company doesn't think you live in WI, it's probably on the part of the provider. It may take some time to get straightened out, so call the billing department right away, and tell them they are billing your insurance wrong, and they need to bill as in-state. At my place, the charges should do away to pending until they hear back, but in my experience it has been such a pain in the butt to get them to bill correctly. I am hoping someone will let me know soon if they can just keep billing wrong or if they are on the hook if they keep doing it wrong over and over.

Either way, what needs to happen is almost certainly that the provider needs to rebill, and do so correctly, but it doesn't hurt to call your insurance and make sure that is in fact the issue and not something going on with the insurance. Document as much as possible, document the calls at home with names and dates, and follow up with an email so there is timed proof as well. That is what i always do.