My Story

The chronicle of the journey from infertility, to miscarriage, to finally raising twin girls born in June 2012.

Tuesday, July 16, 2013

Never take their word for it

K was scheduled for an MRI tomorrow to find out what's going on with his back so we can begin whatever it will take to get him on the mend.

He got a phone call from the MRI place saying they're going to have to reschedule his appointment because they haven't gotten pre-approval from the insurance company.  Well we all know how quickly bureaucracy moves so we were looking at another week or two before we could even diagnose the problem.

Oh Heeeeeyyy-alllll NAWWWW!

It was 4:30pm.  I get on the phone right quick to the insurance company knowing I have 30 minutes to kick their asses, get back to the MRI place and make sure he gets to keep that appointment.

15 minutes on hold before reaching a representative.  Get through preliminaries of getting K's permission to speak on his behalf, date of birth, blah blah blah.  Ok Insurance Person, this is what's happening, get put on hold, the request for that procedure was cancelled.  Why?  I dunno.  Well can I get it pre-authorized?  It doesn't need pre-authorization.  Will you hold on a minute?

Conference in the MRI person.  Hi MRI person, I've got Insurance Person on the phone, they're saying we don't need authorization for this.  They talk to each other about how the request was cancelled, doesn't need pre-authorization, there's absolutely no reason not to do this tomorrow.  Oh nobody will take responsibility for manufacturing some bullshit reason and cancelling the whole shebang, but now that I'm forcing them to talk to each other with me there, since no one will claim they are the reason it's cancelled, well gee, suddenly it's not cancelled anymore and they'll see K bright and early in the morning.  Damn right you will.

Health insurance billing people, this is a general question for you - why is it that every single thing you say, if I question you on it, suddenly that's not the case anymore?  You send me a bill, I wait a week and then call you to confirm my balance.  My balance is always different from what's on the bill, usually it's wiped out completely.  You tell me the insurance company is throwing up a bunch of bullshit to delay procedures so I call the insurance company and usually they declare bullshit on what the billing person told me.  So what's the deal?  Is it all a scam that your bosses force you to participate in to try to get as much money out of people as possible or to rearrange procedures so your doctors can go play golf that afternoon?  Is it just an industry staffed solely by incompetent idiots?  99% of the problems I have with the health industry stem from the billing departments.

I realize it's just numbers and dollars to you guys, but you're inflicting unnecessary physical pain and financial loss on people when you do this.  My husband would have endured additional weeks of pain if he had taken your word for it and possibly been forced onto medical leave from his job cutting our household income by half.  That's food out of my babies mouths because of some sort of paperwork snafu that never should have happened!  There was NO reason to cancel his appointment!

So which is it - incompetence or willful malicious manipulation?  Because your industry is plagued with either one or the other.  I'd just really like to know which I'm dealing with.

1 comment:

  1. I find it really annoying too and a bunch of BS!


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