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.
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.
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, 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 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'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?
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.
All in all, they are trying to do their job and we can help them make better policies if they know what is wrong. Unfortunately we have to deal with this in order to get our healthcare, so take a deep breath and don't get too frustrated. If you really want to avoid this, just be healthy and you'll be fine. - 15275
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.
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, 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 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'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?
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.
All in all, they are trying to do their job and we can help them make better policies if they know what is wrong. Unfortunately we have to deal with this in order to get our healthcare, so take a deep breath and don't get too frustrated. If you really want to avoid this, just be healthy and you'll be fine. - 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.
