You're Asking the Wrong Guy
During a second tonsil cryptolysis procedure, the author learned insurance would not cover it the way it covered the first, and neither the front desk nor the treating doctor could give a clear answer about cost. Billing confusion does not stop at the patient, it follows providers into the treatment room too. MySuperbills exists to keep that room focused on care instead of payment questions.
I was getting my tonsils “zapped” by laser (tonsil cryptolysis) for the second time this year when I learned I would have to pay about $600 out of pocket. I was surprised. Insurance had covered the first treatment earlier this year. What had changed? The front desk couldn’t quite explain and suggested I ask my doctor. He explained that insurance wouldn’t cover the second treatment at the same level, but I needed some additional work and someone had to pay for it.
I decided to go ahead because I didn’t want to reschedule. But while sitting in the chair, I asked a couple more payment questions. I like to understand these things. My very sweet doctor said, “You’re asking the wrong guy the billing questions.”
He was ready to treat me. I was trying to understand what I owed and why. The front desk was trying to help. Yet here we were, at Northwell, a major health system, with a distinguished ENT specialist who had been practicing for decades, and we still couldn’t get a clear answer to a seemingly simple payment question. I usually think about insurance from the patient’s side: the confusion, the paperwork and the follow-up. But for providers, payment questions follow them right into the treatment room!
It reminded me that the work we’re doing at MySuperbills matters on both sides of that chair. At MySuperbills, we want the treatment room to be a place for care, with fewer billing questions getting in the way.
MySuperbills is not a healthcare provider, insurance company, or legal advisor. We are a claim preparation and submission service. This article is general information, not medical or insurance advice.