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.
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, 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.
The most substantial bill that we have received came from the Neonatal doctors that saw my son daily in the NICU. When my son first went in the hospital, we called the insurance to make sure this wouldn't be a huge issue, and they assured us that the hospital and his treatment would be covered. And yet, here I stood with a phenomenal bill from the doctors at the hospital saying that it was our responsibility.
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 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.
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.
Their is always an appeals process to anything going on that you know is incorrect, so don't be intimidated to use your rights as their client. Before you pay a bill, contact the insurance so they can check the system and insure they have done all they are required to do for that particular claim. Then, check again with the doctor's bills to keep them from charging you over the agreed rate they made with your insurance, without you knowing it. Make note of things the insurance company tells you so that if it comes to a misunderstanding, you have a clear recollection of what you were told.
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. - 15224
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.
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, 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.
The most substantial bill that we have received came from the Neonatal doctors that saw my son daily in the NICU. When my son first went in the hospital, we called the insurance to make sure this wouldn't be a huge issue, and they assured us that the hospital and his treatment would be covered. And yet, here I stood with a phenomenal bill from the doctors at the hospital saying that it was our responsibility.
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 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.
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.
Their is always an appeals process to anything going on that you know is incorrect, so don't be intimidated to use your rights as their client. Before you pay a bill, contact the insurance so they can check the system and insure they have done all they are required to do for that particular claim. Then, check again with the doctor's bills to keep them from charging you over the agreed rate they made with your insurance, without you knowing it. Make note of things the insurance company tells you so that if it comes to a misunderstanding, you have a clear recollection of what you were told.
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. - 15224
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.
