Tuesday, November 25, 2008

Health Care?

I spent most of my day dealing with the health care of my family.

Besides we were playing phone tag with our pediatrician about our 5yo (he's fine), I had my annual physical. I get there...surprised that I apparently scheduled a pap smear (I didn't)..then find out that my insurance might not cover the appointment since my ob/gyn listed my annual gyno exam in June as a regular physical. But that got taken care of and I was given a clean bill of health.

After I get home, I decide to finally call the insurance company to ask about several incorrect billings. First I am told that my doctor's office apparently sending the bills in incorrectly...but they don't actually correct the error unless the patient complains...then you have to go through a ridiculous process. I also ask about some lab fees...despite the literature we were given about our plan that simply states 100% of lab fees are covered...really they are only covered if sent to a specific lab. And, here's the best part, it is MY responsibility to tell my doctor to send it to this specific lab. So...there will be a strong letter sent about that. It should not be the patient's responsibility to tell them where to send lab work...especially since we were never told such a thing. So my hub calls the doctor and they say its the insurance companies errors. Blah.

So then, while I was in the mood. I look at our annual change period information on our current insurance (something I ignored until my hub mentioned that so many people at work were complaining about the changes...what changes?). Basically, my hub's work is changing insurance companies so we have to reverify our existence and select new plans. After spending hours trying to figure out if our current drs were covered and trying to factor in the care the pediatrician just recommended for our middle boy....done and done.

Here's the bottom line...we take the time to read the claims, bills, literature and I don't pay unless I know what I'm paying for. But so many people don't...there are billing errors, coverage and lack of coverage they don't know about...but people just pay for it or go see the doctor expecting to get low-cost care. Health care should not be complicated...I should feel comfortable heading to the dr to the care my family and I need.



Ashley said...

Hi Jenna,

This is Erika's sis, Ashley, down here in Fla. E was just in town and kept saying that I have to read your blog, so before I headed out on my "Yipee I have a day off day- so I might as well start it with mind numbing errands :o)!", morning I gave it a read. I was delighted to find that your top post was about one of my favorite past times- dealing with insurance companies! I made a special connection with you as I read about your run in with the big buissness mentality of- if you don't ask the right questions we won't give you the right answers.

Two years ago, when my daughter was twelve, she was injured in a freak circus accident (for real :o) and she almost lost her toe! We had primary insurance, BCBS and the circus insurance, which is AIG. Like I said it's been TWO YEARS and I'm still making phone calls that go like this, "Yes ma'am I faxed the EOB from BCBS to your department at AIG and I am still not seeing the claim on the bill. I'm sorry that the billing department called it workers comp initially, but obviously I wouldn't permit my underage daughter to work at the circus. Please refile the claim!" How are these details even remotely my job? How is it even close to right that we parents need to know what the heck to do when our brain is so distracted by our hearts as we are obviously taking care of someone at the same time we are dealing with a medical issue?

On a separate, but related issue I found out that if you have Verizon wireless service and you work for the city, state, county, whatever, and if you tell them this, then you get 15% off your bill every month! I found this out because I was babbling to the Verizon guy after a long day of getting my Kindergarten room ready for school as he tried to recover my data. I asked if the discount could be retroactive since I've been teaching awhile and he said, "No it can't but since we know now we'll give you the discount." How crazy is that!? Anyway, thanks again for your great post and I'm looking forward to reading more :o)

Mom of Oliver, 8 and Tali, 14

The Fearless Freak said...

Be glad you don't have state insurance. When something goes wrong there, it is a NIGHTMARE getting it fixed. When DH was part-time at work and didn't have insurance we had it and even something as simple as picking a PPC took me WEEKS to accomplish.

I consider myself reasonably intelligent and able to read and understand most things and I seriously felt like I was reading another language struggling through all that mess. I can't imagine how anyone that is uneducated or doesn't speak English would manage it.

Jenna said...

Thanks for reading Ashley! E always says we should get to know each other.