Change your insurance.
We have traditional Medicare, and a supplemental carrier, for the past 4-5 years. We have had no problems, We pay just the premiums, and i have a lot of Dr bills - all I get is a record of bills being paid by medicare and our supplemental.

Have you considered Kaiser? We've had it for 32 years and no complaints--everything under one roof and no paperwork at all.

don't always assume it's the biller(s). I do medical billing and trust me, the insurance companies will give every excuse not to pay correctly...OR pay in a timely manner!

Who is your primary insurance company? Medicare? All payments SHOULD be based on what the primary allows.
All depends on contracted rates that your doctors have with the insurance company. If your secondary picks up copays and deductibles, that is a plus. Some do, some don't. Don't blame the receptionist, she only has access to so much information! :)

Juellie, I completely understand that any individual person only has the information available to them that the company supplies, but then who is supposed to fix these issues? The receptionist takes my insurance information and my co-pay. If I shouldn't be frustrated that she (or he) can't use/read the software correctly and request the correct co-pay, where should the frustration be directed? (Serious question)

My issues are that the medical companies (4 in my cases) aren't even contacting the insurance company. They aren't even keeping the information I have given repeatedly. These companies are not being fair to their customers (me) and to the employees by not having adequate software (or whatever the excuse may be).

Maybe this is an issue where I live?

I have Medicare and a supplemental insurance and have no problems. The office bills Medicare and the secondary insurance pays based on what Medicare paid. No co-pays. We do pay a considerable amount for this insurance tho.

Have you discussed this problem with Medicare, your supplementary insurer, and your Part D insurer? What do these companies tell you you should be paying the doctor's office and at the pharmacy? Are you going to doctors and labs that are Medicare approved?

In 2012 and 2013 we had Medicare supplementary ("Medigap") plans that paid 100% of everything Medicare-approved beyond what Medicare paid. This was a "Plan F" policy. It had an expensive premium, but my DH's former employer offered it at a considerable discount. From what she's posted, I believe Monica has a "Plan F" policy.

In 2014 we have a "Plan F - High Deductible" supplementary. After we've met the Medicare deductible, Medicare will pay its' 80% of approved rates, and we will be billed for the difference until we've met the Medigap insurance's deductible. We are betting that the much lower premium for this policy, plus what we will be billed, will amount to less than the premium alone for the "Plan F" without the deductible. We are still protected against huge medical bills. DH's former employer is still assisting with some reimbursement for medical premiums.

Our Medigap plans have no co-pays. What type plan do you have?

Our Medicare Part D (prescriptions) plan is new to both of us this year. They (Wellcare) caused us a lot of grief with their initial mail orders in January, and we will not be using them again in 2015. Our primary reason for choosing them was because their mail order pricing was better for my DH's medications!

In 2013 my DH's Part D plan (Silverscrip/CVS) was also a disaster at the beginning of the year, but I never had difficulties with my Part D (United HealthCare). Silverscrip was fined by Medicare for its' many failures in 2013.

My supplemental medigap is far from expensive. Just a few dollars more than the Medicare premium. My monthly infusions alone would cost more than 10 times the cost of both Medicare and the supplemental.
I have AARP for prescriptions, and prefer generics when possible.

sjerin - It's great that you've had so many years of good experience with Kaiser. To keep the discussion light, let's just say it's not for everyone.

Kaiser does one thing better than anyone else - they provide really good care for a large pool of customers at an economical price. But since Kaiser is the insurer and the provider under one umbrella, they're incentivized to withhold care, just the opposite of the fee for service model that's most prevalent for others with conventional coverage. I've heard too many family and friend stories about inflexible rules and practices, along the lines of "No, we can't do that unless ....", or "No, we only allow 6 sessions of physical therapy for that injury because ....". WIth conventional coverage and providers, customers can question decisions and change providers (or even insurance companies) when dissatisfied. With Kaiser, it seems one sometimes encounters fixed rules. Has that ever happened to you, or is my information dated?

I hope you never encounter a situation like that.

For traditional insurance companies, complaints (that can be done online) to the state board of insurance are very effective, because the state can fine them. Insurance companies and billing companies have every incentive to bill incorrectly (higher) unless you find the entity (like the state boards) that can hit them in the wallet.

Next time you spend an hour on these varmints, spend an extra 15 minutes and find out who holds their leash, and go jerk them around a little.

Alice, I don't know what you mean by software. does she verify your benefits on line, on the insurance company's website? Does your card state your co-pay?

One example: I have several seniors on Medicare Advantage (United Health Care). It says their office co-pay is $15.00 and a specialist is $30.00 Believe it or not, a chiropractor is $20.00....right in the middle of the two. But it doesn't say this on the card. I only know because of experience. It's not at all as clear cut as an insurance card may look!!! It's frustrating for the provider as much as it is for the patient!!!!

Snidely--that is not at all the case here. We have never had any problems getting what we ask for. When my dh had a couple of possible mini-strokes a few years ago they were on him like glue and gave him every test under the sun. Never have we had a complaint about service. I understand not all Kaisers have the same level of service, but in this area, which I assume is Alice's, we have award-winning insurance coverage. My sister had problems with her East-coast Kaiser experience years ago.

Monica -- Sorry. I 'presumed'. Because your supplementary pays 100% of the Medicare approved costs beyond what Medicare pays...I assumed that yours is a "Plan F" and that it would be as high a premium as we were quoted for one for 2014.

We took "Plan F- High Deductible" with a $2K deductible for 2014. It is $165/mo total premiums for two. The 2014 "Plan F" premium with no deductible was much more.

Our plans certainly lost money on me in 2012-2013, but I don't anticipate many medical problems for either of us this year --hence the deductible gamble. I did hate to give up the 100% coverage, partly because I could ignore incorrect bills. Whatever was really owed would be paid by Medicare + the "Plan F".

It's only six or seven months until Seniors get to go through the selection process all over again for Medigap and Part D plans. Ugh! What a backwards system!

I too live in the Bay Area, my "family and friends" comment relates to experiences with Kaiser locally and in So Cal.

I'm glad you've had great service and I hope it continues. The link below will lead you to a long list of Kaiser horror stories.

Here is a link that might be useful: Kaiser stories

Yes, I'm sure you could find "horror stories" for any insurance carrier.

Sjerin, I'm glad you like Kaiser. (sincerely) I have only heard one good thing about them from all the friends, co-workers, and acquaintances we know who have Kaiser. Also, I'm not willing to drive 30 minutes each way to see a doctor or go to a hospital.

Juellie, I see what you're saying. Co-pays are listed on my cards, and I mention software because that's what they all keep blaming. Several have said their software is supposed to connect to the insurance companies to verify, when that doesn't work out, no one wants to make an actual phone call. They just want me to pay, which is why my husband had to wait in target for an hour. They never did make phone calls. The staff looked up what we'd previously paid, which matched what my husband told them, so they let him just go with my meds.

I believe you, Alice. :)

Honestly, I think its reputation is unfair but I take no offence, Snidely.

"I take no offence, Snidely."

I'm very glad, none was intended in any way, shape or form. With so many happy years as a Kaiser patient, your own experience says a lot.

alice, they must be using electronic medical records or something. I do not have software that hooks me up to insurance companies.

I have to go on each individual website to verify benefits. And then it usually isn't very inclusive, so I end up making a call. I never leave it up to the patient! To many surprises that way (for them and the office!!).