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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.
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.
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.
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?
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.
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.
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.
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.
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.
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.
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?
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.
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.
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.
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.
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