When we moved to New Jersey, I was already 24 weeks pregnant. Of course, I didn't know anyone who could give me a recommendation for a good obstetrician, so I just ended up going to one of the first places I called. Fortunately, I ended up loving my new doctor. Her office and the hospital she worked through both accepted our insurance, which was great.
Being the slacker that I am, I failed to look for pediatricians before
Porgie was born. So, I just ended up taking her to the pediatrician that took care of her in the hospital. Being the naive girl that I am, I just assumed that they accepted my insurance.
Since
Porgie's birth, we have been receiving numerous bills from the pediatrician's office. I honestly never analyzed the bills, I just paid them.
On Friday I received a bill for
Porgie's nine month check-up. The bill was for $106.00. According to the bill, I was responsible for $85.00, the insurance company was responsible for $0.00, and there was an adjustment which subtracted $21.00 from the bill. Now, I might be a little dumb, but this bill obviously was incorrect. Why would I be responsible for 80% of the bill.
I called my insurance company to bitch, when the girl on the other end explained that they do not pay for out-of-network doctor visits. What? I explained that I went to an OB who worked for Cooper Hospital (who accepts my insurance), delivered my baby at Cooper hospital (who accepts my insurance), and took my daughter to the pediatrician who checked her out at Cooper Hospital. Obviously, the pediatrician had to be in-network too.
The lady on the other end proceeded to tell me that the office where I have been taking my baby is not in-network, nor are any of the doctor's from that office. I was stunned. How could no-one have told me?
Sure enough, I went back and looked at the bills we received after
Porgie's birth. The OB and hospital expenses were covered (at least partially) by our insurance. However, our insurance company failed to pay any of the pediatrician charges - even for the initial newborn care in the hospital.
I am extremely confused. How can an insurance company accept charges from the OB and the hospital, but not the pediatrician? When you have a baby, there are several people who have to be present in the hospital - like the pediatrician. I just don't understand.
With a heavy heart, I decided that I had to change doctors and hospitals. The only other hospital close to our home accepts our insurance, but guess what? The
OBs from that hospital do not accept our insurance.
AHHHH!
I am so fucking frustrated. I want to rip all of my hair out. FUCK!