Costco-size can of whoopass

I'm ready to open one on the insurance company.

I got another statement in the mail today, and they are now denying my psychological evaluation in its entirety, to the tune of $520.00. (!) They are claiming the service was not only not "preauthorized", but that it was performed by an out-of-network provider.

I stood right next to the office person in the provider's office while she "preauthorized" it, the day it was scheduled, and specifically used this provider--out of several in the office--because he was the only one covered by my insurance. (I didn't even want to go to him! He wasn't terrible or anything, but I prefer to see female medical professionals whenever possible. It's a my-own-comfort-level thing.)

So I called the insurance company, who told me that this provider is not in network under his tax ID number. They also told me the claim had been forwarded to the behavioral health division. I explained for the 5,000th time that it was a medical claim, not a behavioral one, which they concurred, and which doesn't help me one iota since he is apparently not in network.

WHY would the office person tell me the provider is covered if he isn't? Did she pretend to talk to someone on the other end of the phone while I stood there? I'm stumped. I called the provider's office, and of course the billing person isn't there until Monday. Conveniently, Monday is my next nutritionist appointment, so I guess I get to take this up with the staff in person. (Oh, joy!)

If I have to pay this entire amount out of pocket, at least the tax return is coming, but it makes my going back to school an elusive pipe dream. I guess I will go through the motions of applying just the same, in the hopes I can still get in and receive student loan funding.

This certainly removes any mystery surrounding the reasons that, on any given day, I'd rather crawl back under the covers and stay there, or sit in a nice, dark, silent room with no other people in it. Pffffft.