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Tuesday, January 31, 2012

Insurance Rant

This is a big that I lost sleep over last night and will probably continue to lose sleep over for years to come. Insurance. I KNOW I am not alone in this and that half the country is dealing with similar issues or worse. The numbers of people that are living without insurance are staggering so I know I am lucky to have such good insurance. Really, I know I am. The boys meds alone costs $12,000 a month without insurance. Because we have good insurance, we only pay a copay. You can then appreciate the fear that we had when Leo was out of work. Our insurance does two annoying things. One is that once in awhile you have to send something in to say you don't have any other insurance and second, every time one of us goes to the lab or Urgent Care, we have to send something back with Leo's signature. Until we do, they won't process the claims. Whatever. It is tedious and not what this rant is about. With two kids that have chronic issues and all the medical stuff I had last year, we had a lot of doctor's appointments and a few surgeries with some emergency room visits.

All of a sudden, I was getting a lot of bills that the insurance wouldn't cover. I called and was shocked to find out several things. One was that the anesthesiologist wasn't in network so we had to pay out of pocket. I painstakingly found a doctor that was in network at a hospital that was in network. No one told me that I had to or even could choose my anesthesiologist. Along those same lines, I picked an oral surgeon for the biopsy of my tongue. I called and made sure it was covered. I didn't know that it was up to me to tell him what lab I wanted the sample sent to. The lab wasn't in network. It's my own ignorance from not having dealt with this before that I didn't find out if he could send it to another lab.  I didn't even know it was an option. I took Tommy to the ER when he had those bumps on his legs and couldn't walk. I took him to a hospital in network. They ran a bunch of tests never once telling me that I should call and make sure they were covered. How in the hell am I supposed to know in an emergency situation that one of the tests isn't covered?! I called the hospital and asked that the paperwork be sent to me so I can appeal it with the insurance and that I was working on getting it paid and to not take further action. I still haven't gotten the paperwork. Instead, I got a call that they sent it to collections. I am fuming! I know this stuff happens all the time and Leo has assured me that it is going to get taken care of but I hate this crap so much! I followed their stupid rules. I called to make sure it was covered. I went in Network and I still get slammed with uncovered services. Again, I know I am lucky to just have insurance. I get that but with Nico and Tommy and the endless appointments that might be ahead, I feel like there is no light at the end of the tunnel of dealing with insurance issues. It just fires me up that the insurance companies will go to any length not to pay a bill that they are supposed to...that and the gazillion loop holes that get them out of paying. It takes a mountain of paperwork and hours of time and arguing (and I really hate confrontation) before they will do what they are supposed to do. So frustrated right now. You know, I used to fantasize that if I came into a lot of money I'd get a nanny or a housekeeper or a cook or maybe even a driver? Well, not'd get an assistant to take care of insurance issues. Do you know how hard it is to take care of things over the phone when you have a 2 year old screaming for "SNACKIES!!!" or "'Mon, Mommy, 'mon!!!" (c'mon, Mommy) or "Pickee upee!"


At January 31, 2012 at 10:32 AM , Blogger sloyer_d said...

WHY then never tell you that you have to hand pick every practitioner in the room is frustrating. they should come in a package deal. We call on the DR and hospital. We should not have to call on every RN, Anesthesiologist, xray person...lab person. To me its just more ways to squeeze money out of us. grrrrrrrrrr this makes me mad too

At February 1, 2012 at 5:32 AM , Blogger AnnMarie said...

I know! I'm still pretty worked up about it.


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