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.
It is sad really because we are only college students paying for the campus health insurance, which is pretty low budget, and they expect all our health needs to first be seen at the on campus health center. When my son was born, we happened to be in a different state, so going to their health center was a little out of the question. Since we cannot afford to take our son on a plane to their on campus health center every time he needs to go to the doctor, which was quite a bit, we are being held responsible for these kinds of bills.
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, I asked the insurance company if they ever actually communicate with the health center before they write their policies. So you understand that we are paying out of our pocket because we didn’t go where the insurance wanted us to go get his shots, when they don’t even give shots anyway. Are you appreciating the hilarity of this ignorance? I hope so.
The mother of all our bills came from the doctors at the NICU that daily visited my son in the hospital. Let me first clarify that when my son was first admitted into the hospital, we called the insurance to make sure that this was ok and everything would be taken cared for. Regardless of their reassurance, the bill came stating our insurance’s lack of coverage.
Apparently they cover the hospital, but not the doctors that work there. Because it is an option to go to the hospital without seeing a doctor. That totally defeats the purpose of going to the hospital doesn’t it? So, I’m at a loss to how this policy 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.
I envision a man in the dark corners of the insurance building who has never set foot in a doctor’s office, that is hired for his ability to write complex and contradicting policies. In fact, the employees themselves must devoid of any medical need or else they would be blatantly aware of their flaws themselves. I’m not surprised that so many candidates used it as a topic of debate in 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.
Their is always an appeals process to anything going on that you know is incorrect, so don’t be intimidated to use your rights as their client. Before you pay a bill, contact the insurance so they can check the system and insure they have done all they are required to do for that particular claim. Then, check again with the doctor’s bills to keep them from charging you over the agreed rate they made with your insurance, without you knowing it. Make note of things the insurance company tells you so that if it comes to a misunderstanding, you have a clear recollection of what you were told.
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.