The joy we had when we brought in the arrival of our first child, was nothing in comparison to the joy we felt beginning our relationship with the insurance company. We hoped that the last thing we would have to worry about when caring for our premature baby was how to pay his medical bills. The following is all the hilarious and unbelievable situations that have arisen from the insurance company.
Firstly, we received a bill shortly after this whole experience for the transportation of our son from the hospital he was born in, to the children's hospital where he was being cared for. This bill was near $1,000, and the note on the bill said our insurance had denied coverage because it was not a medical necessity. So, I guess it really was our fault that we didn't try to plug the incubator into the cigarette lighter of our car first. Since, it has been appealed and 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.
For example, his immunizations were administered to him at the pediatrician's office. But since they weren't given to him at the health center, we pay for them out of pocket. We have now moved back to campus and happily went to the health center to get him up to date on his immunizations. You can imagine my surprise when they told us that they don't offer immunizations at the health center, you have to go to a pediatrician!
So, the insurance company obviously writes their policies without ever communicating with the health center. We are held responsible for not going to the health center for services that they don't even offer. Is this as funny to you and it is to me? 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?
It seems that the doctors that worked in the hospital weren't covered, even though the hospital is covered. I forgot that it wasn't important to see a doctor while you were in the hospital and should have opted for my son to not be seen by them. What's the point of going to the hospital without seeing a doctor? I don't see how this works.
It is naturally being appealed for the lack of sense it makes along with the lack of options we had once he was admitted into the hospital. Especially since I was still in the hospital when he was admitted. A small band was put on his ankle as a safety precaution that kept us or anyone else from taking the baby even to the elevators. Aside from those excuses, we wanted the best care our three pound son who needed help with the simple task of breathing without having a second thought about what the insurance was going to do.
I'm assuming that there is a man somewhere in the depths of the insurance company who makes his living out of writing confusing no nonsense policies about receiving medical treatment when he himself has probably never been to the doctor. Apparently when you work with insurance you are miraculous free from any kind of medical attention, or else they would be most astute at making it easier to use their policies. I wonder why it was such a topic of debate at the last election?
Believe it or not, there are people we found within the insurance company with a knowledge of their flaws and a desire to help. So, when you do finally meet these people, it would be wise to ask them if they could personally assist you in all your further claims. Maybe if it feels appropriate, even get their email and extension so you can get directly to them without wasting time with the call center ignoramuses that got the job because they can read a prompt. That is the mostly useful advice I can give.
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.
Firstly, we received a bill shortly after this whole experience for the transportation of our son from the hospital he was born in, to the children's hospital where he was being cared for. This bill was near $1,000, and the note on the bill said our insurance had denied coverage because it was not a medical necessity. So, I guess it really was our fault that we didn't try to plug the incubator into the cigarette lighter of our car first. Since, it has been appealed and 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.
For example, his immunizations were administered to him at the pediatrician's office. But since they weren't given to him at the health center, we pay for them out of pocket. We have now moved back to campus and happily went to the health center to get him up to date on his immunizations. You can imagine my surprise when they told us that they don't offer immunizations at the health center, you have to go to a pediatrician!
So, the insurance company obviously writes their policies without ever communicating with the health center. We are held responsible for not going to the health center for services that they don't even offer. Is this as funny to you and it is to me? 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?
It seems that the doctors that worked in the hospital weren't covered, even though the hospital is covered. I forgot that it wasn't important to see a doctor while you were in the hospital and should have opted for my son to not be seen by them. What's the point of going to the hospital without seeing a doctor? I don't see how this works.
It is naturally being appealed for the lack of sense it makes along with the lack of options we had once he was admitted into the hospital. Especially since I was still in the hospital when he was admitted. A small band was put on his ankle as a safety precaution that kept us or anyone else from taking the baby even to the elevators. Aside from those excuses, we wanted the best care our three pound son who needed help with the simple task of breathing without having a second thought about what the insurance was going to do.
I'm assuming that there is a man somewhere in the depths of the insurance company who makes his living out of writing confusing no nonsense policies about receiving medical treatment when he himself has probably never been to the doctor. Apparently when you work with insurance you are miraculous free from any kind of medical attention, or else they would be most astute at making it easier to use their policies. I wonder why it was such a topic of debate at the last election?
Believe it or not, there are people we found within the insurance company with a knowledge of their flaws and a desire to help. So, when you do finally meet these people, it would be wise to ask them if they could personally assist you in all your further claims. Maybe if it feels appropriate, even get their email and extension so you can get directly to them without wasting time with the call center ignoramuses that got the job because they can read a prompt. That is the mostly useful advice I can give.
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.
About the Author:
Haylee Landford is the mother of a premature baby with another on the way. She frequently writes articles for Land For Sale as a guest author.
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