Need a new Insurance Company?
Nothing compares to having your first child and sharing in all the joy that comes with it, that is nothing except starting your dealings with the insurance company. In the cases of premature babies, the last thing on your mind in the payment of medical bills. Regardless, let me share with you what comedy has occurred since we have began our relationship with our insurance policy.
First, my son was transported from the hospital where I delivered, to a children’s hospital across town, and we received a lovely bill shortly after his delivery. The $1,000 bill was coming to us to pay, because according to the company our insurance denied payment on account of it not being a medical necessity. Our response was, did you expect us to plug the incubator into our cigarette lighter and drive him ourselves? Since our appeal, it has now been covered.
Since our plan is a bargain plan that they give to college students, they expect that we first go to the on campus health center for all our health needs. Since we lived in a different state than the university at the time this happened, we hardly had a choice to go to the health center. So we are being held accountable for not buying an expensive plane ticket across the country every time we needed to take our son to the doctor, which was a lot.
Especially in the topic of immunizations, we needed to get them at the pediatrician’s office. Then we were told they weren’t covered because they weren’t given at the on campus health center. So, now we have moved back on campus and I took my son to the school health center for him to get updated on his shots. Would you believe that they don’t even give immunizations at the health center?
So, apparently very little communication transpires between the policy makers of the health coverage at the insurance company, and the employees at the on campus health center. We need to pay out of pocket for not getting our services at the insurance’s designated place that doesn’t offer the services we need anyway. Are you as frustrated right now as I am? Good.
Another conundrum follows a pretty substantial bill we received from the Neonatal doctor’s office that saw my son daily in the NICU at the hospital. We talked with the insurance when this first happened and they assured us that the hospital was covered and would be no problem. So why did we get a bill for the doctor that treated him there?
As it turns out, our insurance does cover that hospital, oh, but the doctors that work there are not covered. I should have chosen the option for my son to be in the hospital without ever seeing a doctor. Isn’t seeing a doctor kind of the point of going to the hospital? So, maybe someone can help me understand how this makes any sense.
It is also being appealed on account of the policy making no sense, along with the complete lack of control we had in the doctors seeing our son anyway. My son went to the hospital while I was still in the hospital myself. Then they put a safety device on his ankle that prohibits anyone from taking him even as far as the elevator without being arrested. Plus who would say, please don’t take care of my three pound son that can’t even breath by himself because there’s a chance the insurance won’t cover it.
The insurance company must employ a man somewhere in their crevices that has never been to the doctor in his life, and he is the one assigned to write the policies of how it is to be done. It seems that all the employees at these companies must miraculously be free from needing any sort of medical attention, or else they would be more aware of the problems that exist in their policy. No wonder it was frequently a topic of debate for our last election.
Luckily, the insurance company has people in it that also see the problems in the system and are trying to help. The key is to find those people and ask if they will personally help you in all your claims for the future. Get their personal extensions and emails so that you don’t have to deal with the phone center customer service know-nothings that will just hand you the standardized statements of policy. I have found this to be useful.
Don’t be afraid to question what they are doing, because there is always an appeals process you have a right to. Check with the insurance and the doctors before you pay bills to make sure the insurance has done all they can. Also, to check that the doctors are not overcharging you despite deals that they have made with the insurance. Keep good notes on what the insurance company says to you when you do speak to them, so it can’t be rebutted.
What it comes down to is that these people are trying to do their job, and we can help them know how to improve in it. It can’t be helped dealing with this in order for us to have healthcare, so all you can do is take a deep breath when you are frustrated. The best way to avoid these problems, just don’t get sick, and you’ll be fine.
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