With all the joys that come in having children, the silver lining is, of course, dealing with the insurance company. After having a premature baby, we hoped our last concern would be how to pay for his care. instead many quite hilarious situations have entailed in our insurance dealings.
My son had to be quickly taken to another hospital when he was born that had an equipped NICU, and the bill to make this little drive was the first to arrive. The insurance had denied payment on this $1,000 because they didn't see it as a medical necessity. The only thing I could think of was that they expected us to try and plug the incubator in our car's cigarette lighter. We wrote an appeal, that has now made it 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, 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.
The most substantial bill that we have received came from the Neonatal doctors that saw my son daily in the NICU. When my son first went in the hospital, we called the insurance to make sure this wouldn't be a huge issue, and they assured us that the hospital and his treatment would be covered. And yet, here I stood with a phenomenal bill from the doctors at the hospital saying that it was our responsibility.
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.
Of course, we are appealing this bill since it is mindless, and we really had very limited control with what went on with our son in the hospital anyway. I was still in the hospital myself when my son was admitted to the NICU. The safety devices they use in the NICU consist of a small band around his ankle that alerts security to come and arrest us if we even take him to the elevator. Most of all, what parent would say, please don't assist my three pound baby with his breathing, because I'm not sure the insurance is going to come through here.
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.
Remember that you are a client with rights, and you can question or appeal anything that you see going on that doesn't seem right. Contacting the insurance company before you pay the bills when they come will prevent overpaying bills that the insurance may still be working on. Doctor's offices also sometimes will continue charging you the full bill even after the insurance has made deals with them for a lower price, and you should be aware is this is happening. Even writing down conversations you have with the insurance will benefit if any miscommunications arise, so you can verify what you were told.
In reality these are just people doing a job, and it might help them if we show them how they can improve. It is just a fact that dealing with the insurance is part of getting healthcare. The only way to avoid it, well, don't get sick.
My son had to be quickly taken to another hospital when he was born that had an equipped NICU, and the bill to make this little drive was the first to arrive. The insurance had denied payment on this $1,000 because they didn't see it as a medical necessity. The only thing I could think of was that they expected us to try and plug the incubator in our car's cigarette lighter. We wrote an appeal, that has now made it 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, 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.
The most substantial bill that we have received came from the Neonatal doctors that saw my son daily in the NICU. When my son first went in the hospital, we called the insurance to make sure this wouldn't be a huge issue, and they assured us that the hospital and his treatment would be covered. And yet, here I stood with a phenomenal bill from the doctors at the hospital saying that it was our responsibility.
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.
Of course, we are appealing this bill since it is mindless, and we really had very limited control with what went on with our son in the hospital anyway. I was still in the hospital myself when my son was admitted to the NICU. The safety devices they use in the NICU consist of a small band around his ankle that alerts security to come and arrest us if we even take him to the elevator. Most of all, what parent would say, please don't assist my three pound baby with his breathing, because I'm not sure the insurance is going to come through here.
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.
Remember that you are a client with rights, and you can question or appeal anything that you see going on that doesn't seem right. Contacting the insurance company before you pay the bills when they come will prevent overpaying bills that the insurance may still be working on. Doctor's offices also sometimes will continue charging you the full bill even after the insurance has made deals with them for a lower price, and you should be aware is this is happening. Even writing down conversations you have with the insurance will benefit if any miscommunications arise, so you can verify what you were told.
In reality these are just people doing a job, and it might help them if we show them how they can improve. It is just a fact that dealing with the insurance is part of getting healthcare. The only way to avoid it, well, don't get sick.
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.
0 comments
Post a Comment