All done

Here's an update now that this is all settled.

I went to the Dartmouth-Hitchcock International Travel Clinic rather than Penn Travel Medicine. Foremost, the DHMC Travel Clinic did submit claims to insurance and seemed to provide a better customer experience overall.

My Aetna insurance ended up covering the "Clinic Visit" and "Preventative Care Services" categories, but not "Pharmacy". See the statement below:

Therefore, I received a bill for $331.43. This consisted of the following two items:

• YELLOW FEVER IMMUNIZATN,LIVE,SUBCUT (49281-0915-05) - 90717 $252.20
• TYPHOID VACCINE, LIVE, ORAL (69401-0000-02) - 90690 $79.23

Note however that the DHMC Travel Clinic has a separate price for procedures that are "uninsured or non-covered", and we had a print-out of the à la carte "Travel Clinic Prices" table to prove it.

I called Conifer Health Solutions at (844)808-0730, which is the entity that takes care of DHMC billing. They were under the impression that the uninsured discount was all or nothing and couldn't be applied to specific non-covered procedures. I mentioned that the price menu indicated otherwise. They had me email my documentation to conifer-dh-customerservice@coniferhealth.com.

I never got a reply to my email, but followed up with another call. This led to my balance decreasing by a $192.89 adjustment. So in total I paid $168.54 ($138.54 + $30 copy). Not bad for yellow fever and typhoid fever!

But the experience shows just how much time the arcane medical billing and insurance system wastes, invariable driving medical inflation. Also Aetna really should cover all preventative vaccinations.

Notes for the future: I do think it makes sense to submit your claim, even if the medical provider does not. Never know what the insurance will end up covering.