Wednesday, October 24, 2018

We Experience What Happens When Providers Submit Bills Directly to Liberty

We’ve had two appointments this year that were with providers other than our normal healthcare provider. One was a Minute Clinic appointment at our local CVS drugstore for an ear infection and another was a dermatology appointment for my wife. In each of these cases, the provider indicated they would send the bill directly to Liberty. Here’s how each provider managed Liberty:

Dermatologist – At the time of check-in they asked for my wife’s insurance card. She indicated we were with Liberty to which the receptionist indicated, “OK, we’ll submit the bill directly to them.” My wife was charged $75 at check-in for the appointment. A bill for $115 did arrive in our ShareBox for the appointment. Liberty processed the bill with $91.28 going to our Annual Unshared Amount (AUA) and $23.72 being classified as the “Adjusted Amount” which is defined as “Improper Balance. Member not Responsible.” (Again, on the communication side, it would be nice to better understand why these get pushed to the “Adjusted Amount” category and don’t count towards our AUA). I can guess what that means but it would simply be guessing. All we know is that it seems we paid $75 for an appointment that apparently cost $115. Since this isn’t a reimbursable charge it is highly possible we’ll receive a bill for $40 ($115 total cost of the appointment minus the $75 we already paid) from the dermatologist. The appointment occurred in July and we haven’t received any further bills so we aren’t sure what will happen.

CVS Minute Clinic – This appointment was for a basic ear infection for our son. In this case, we didn’t pay anything at the appointment. CVS indicated they would send the bill directly to Liberty (not sure if they knew who Liberty was or not). This appointment occurred in late August and as we approach late October we have still not seen the bill arrive in our ShareBox. We have no idea what happened.

So we haven’t had a ton of experience with providers submitting directly to Liberty but we did want to share these limited experiences. We can see how the efficiency of Liberty would improve if your healthcare provider submitted bills directly to Liberty. That said, the lost bill from CVS and the chance we’ll still hear that we have additional charges at the dermatologist could add some inefficiency. We’ll keep you updated on whether there is any change to this situation.