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.
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, 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.
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.
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.
Miraculously, we have found people in the insurance company who have the rare quality to actually want to help you. We found the key is that when you come across these people, ask them if they will personally help you in all your claims in the future. Even asking if it is appropriate to have their email or personal extension so as to avoid the mindless phone reps that only can read from a prompt of how to direct your problem. This has been most useful in our circumstance.
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. - 15275
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.
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, 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.
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.
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.
Miraculously, we have found people in the insurance company who have the rare quality to actually want to help you. We found the key is that when you come across these people, ask them if they will personally help you in all your claims in the future. Even asking if it is appropriate to have their email or personal extension so as to avoid the mindless phone reps that only can read from a prompt of how to direct your problem. This has been most useful in our circumstance.
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. - 15275
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.
