My Response

At 6:56am, the ex wrote:

“Provider of service told me that the (denial) EOB was mailed to you, and that no EOB’s were sent to (provider of service) as noted by the email. Normally the EOB is sent to the insurance holder not to the clinic. How would I or (the provider) know what the EOB says if neither of us has received one. You must have received one to know what it says. You seem to remember what? (Provider of service) policy and procedure manual. Maybe you should stick your nose into this more and contact (provider of service) and tell them what to do just like everyone else. Again, I have never seen a (Reciprocity) EOB to see what they say should be billed or not but apparently you have seen them. AGAIN I HAVE NEVER SEEN A (RECIPROCITY) EOB AND APPARENTLY NEITHER HAS (PROVIDER OF SERVICE) OR (LOCAL) HOSPITAL BUT YOU HAVE. IT BECOMES DIFFICULT WHEN YOU ARE CONTROLLING MY INSURANCE AND WHERE WE HAVE TO GO TO THE DOCTORS. WHY CANT YOU JUST REMOVE (DAUGHTER) FROM YOUR INSURANCE THE SAME WAY YOU DID FOR (SON). THINGS ARE SO MUCH EASIER WITHOUT YOUR INTERFERENCE.”

At 9:10 pm, I wrote back: *(POS) aka Provider of Service*

” Well, sounds like you have contradicted yourself lol. If (provider of service) told you that the eob was sent to Keith, then (POS) gave you the wrong information, as proven by (Reciprocity) customer service and Visiting Members department conversations with (Rep she spoke to) and I. Maybe (POS) should check their eob’s closer, and document all transactions on them, denials, payments, etc. Maybe they should work off an aging report so they can keep track of which patients of theirs have had their claims paid and which one’s haven’t. (just a suggestion- aging reports are sooo helpful and great to work off of.) Some insurance companies send eobs to the provider only (especially if they are paying a claim, and as in this very case), and some send eobs to both. If (Reciprocity) (I meant *POS) would bill (home plan) like they have been told to do by (Reciprocity) then an eob would be produced and could be sent to you. Until they do, there is no eob. *POS would know because they know how the insurance companies they deal with work, they should know the procedures. Strange, they didn’t seem so “unknowing” of these procedures last year. You would know if one was sent to you, but since you gave Keith the option the option to fax them last year, you lost your chance. :-), because now we don’t get them. (He wasn’t supposed to get them last year either, but they sent a few anyway, shhhh! Our secret, ok? <wink<) Nope, never read *POS policy and procedure manual. Don’t care to. (male REP) send Keith an email last November saying he would have their system set up to bill (Home Plan) as a courtesy. I know today (female Rep) in Customer Service at Reciprocity (that I spoke to) said she would talk to him about billing (Home Plan) as well. OOOOO had to get nasty huh? None of this is my concern. I was just helping Keith out. I know how to use the insuraunce correctly. I know how to use the correct providers. Maybe you should learn how to do the same so these little problems don’t happen anymore. 🙂 You know, I have seen a few eob’s from (Reciprocity), not very pretty. (don’t mean any offense to (Reciprocity of course). The original ones are just black and white, and last year, when Keith faxed a couple off to (*POS), I am sure they still were black and white. Now, (Home Plan) eob’s are quite colorful. They are on a sort of “teal” color papers, you gotta like the color teal to appreciate (Home Plan’s out of the norm, colorful eob’s. 🙂 Why are you yelling? Of course I have seen the eob’s from (Reciprocity). so have you. I know for a fact you have seen eob’s from (Reciprocity) because we have had them before, several years ago., and they were sent to you them. They really haven’t changed much either. Last year, you told Keith to fax them to (*POS) and that’s what he did. In fact, one time, (male Rep) said he didn’t need it because we had one, but Keith faxed it anyway, “just to be safe.” So we know for a fact that (*POS) has received them. Oh, and (Local) Hospital…now I know they have too because they are the ones that billed (Home Plan) for the bill from October 2003, and they couldn’t have done that without the eob from (Reciprocity). Are you feeling left out? you must be since you are yelling. 🙂 Nothing to get so mad about, really. It’s just paper, lol. Uh oh, you are yelling again, (or maybe your caps got stuck?) LMAO, controlling your insurance? Now how in the world can I do that? Is this like causing your divorce from (2nd husband)? (gosh, the power you give me!) No one is controlling where you have to do to the doctors, let alone your insurance lol. Clearly, you don’t use (Reciprocity) contracted providers because if you did, none of this would be happening, and if I was “controlling” where you have to go, you most definitely would be using Keith’s insurance like they way you are supposed to. If he can’t control where you take (her daughter), how can I? lol… As far as removing (her daughter) from Keith’s insurance, I can’t do that. He has to. I didn’t remove (her son) either. I don’t have that power (or control) either. (Her son) got himself removed, Keith just signed the paper. Gosh, you STILL hung up on that? time to move on, I am sure (her son) has. Gosh, I never realized how much power your give me, amazing.”

BTW, when Keith removed his son from his insurance, his son was 19 years old. Keith’s ex threatened lawsuit for him keeping their son on is insurance past his 18th birthday, LMAO….


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