A few months ago, Jennifer had an eye exam & new spectacles, from our regular optometrist. We’ve been going there for years, they’re…okay. (Jennifer likes them. I’m not so sure.)
In previous years, an eye exam and new spectacles would cost $50: a pretty good deal. But this year, we got a letter: Provider out of network. Claim denied.
Jennifer called the insurance company, whose customer service person said: Provider out of network. Claim denied.
The provider in question was in network, last year. What happened? Some warning of their change in status would have been appreciated, but I wasn’t really surprised to have had none. (I’m cynical about insurance companies. I expect to be treated shabbily by them. They seldom disappoint me in this.)
Weeks passed. We received an invoice from the optometrist: Claim denied. You owe $385. Pay up, deadbeat.
I procrastinated a bit, but finally put a check in the mail. (What else could we do? Argue with the insurance company? That trick never works.)
Imagine my surprise, then, to receive in today’s mail a second Explanation of Benefits letter from the insurance company: Jennifer’s eye exam is covered, and instead of $385, we owe…$50. There’s no hint of who screwed up what, the first time around; now, suddenly, all is well again.
Is it worth the effort of trying to find out why? Probably not. (I am too cynical to expect an insurance company to own up to its mistakes.) But if the optometrist doesn’t refund $335 very soon, they’ll be hearing from me.