Nothing compares to having your first child and sharing in all the joy that comes with it, that is nothing except starting your dealings with the insurance company. In the cases of premature babies, the last thing on your mind in the payment of medical bills. Regardless, let me share with you what comedy has occurred since we have began our relationship with our insurance policy.
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, 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.
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.
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.
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.
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.
