Insurance woes.

I asked my mom once in college if being an adult meant putting out fires all day long.

She said yes.

In many ways, that’s what being an adult feels like. Solving one crisis after another, day after day. Don’t get me wrong — I like making my own decisions. It just gets stressful sometimes.

Recently I have been fighting with my former OB’s office, my insurance company, and the 3rd-party company that handles claims. This dispute has been going on since the beginning of June. I am quite over dealing with all of them now.

It all started when someone at the OB office marked the wrong office billing code for my 7 week ultrasound. Pregnancy is not a pre-existing condition with our insurance, but because they marked the wrong code (“absence of menstruation”, instead of “pregnancy”), our claim was denied for my ultrasound. We fought with the claims people and figured out that we needed to get the code changed. Then, they said, our claim would be processed and approved.

I called the OB’s office, told them what was up, and they assured me that they would change the code to the correct one and resubmit the claim. OK, good, that fire was taken care of.

So I thought.

I got another letter from the claims people. This time it said our claim was denied because they needed the “office notes” or some such nonsense from that visit. I called the claims people AGAIN, asked what that even meant. They explained that because the medical code changed, the diagnosis changed, and they needed the office notes from that visit to explain why the diagnosis changed.

The diagnosis never changed. I was always pregnant. The code was marked wrong. I kind of yelled at the lady, and said that it was extremely frustrating to do what they asked, only to find that we also needed this other thing because they asked us to do this one thing. Ugh.

The lady assured me that if they got the office notes, they claim would be processed and we’d be approved. This was on August 8th.

Well, I got this bill from the OB’s office because we changed to my current midwife. The bill said that insurance was pending. I waited. I waited some more. I called the claims people AGAIN to find out what the hold up was. The lady said that they were still waiting on the office notes from the OB’s office.

I called the OB’s office to ask if the claims people had actually requested the office notes and to see if they had sent them along yet, and if not, why not. Because the office notes were a change in diagnosis, technically, the OB himself needed to sign some form, and the receptionist said that it was “in the big pile on his desk” and that “he’d get to it when he got to it.”

OK fine. Except that the OB office sent us another bill, now with a late fee, that still said that insurance was pending and needed more information.

I am not paying them one red cent until the doctor signs the form and the claim is processed and approved. I am also not paying this late fee I was charged because it’s not my fault that the office notes haven’t been sent along yet — the hold-up with the insurance is with the doctor himself, not me.

Ugh. I hate dealing with insurance. None of this would have been a problem if they had marked the right billing code to begin with. But now it is this huge fire, and I hope they don’t send this bill to collections for non-payment. I would have paid for my fair share a long time ago had he just signed the gosh darn form and sent it to the claims people for approval.

I mean, how ridiculous is this? ARGH. How hard is it to sign your name on a form? I know, he’s a doctor, and I am sure he didn’t become a doctor because he liked filling out forms. But really now. Stop sending me bills for things that right now are out of my hands.

I also just called the OB’s office. At 3:20 on a Friday afternoon, the office was closed. Have fun golfing. Have a lovely golf-filled weekend of golfing, doc. GRR.

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2 responses to “Insurance woes.

  1. Frustrating! I have been doing lots of paper work from getting married and all and it isn’t fun.

    You seem to be on top of things which is good though. Keep it up. I am trying to work on my “on toppness” with medical bills–they aren’t my favorites!

  2. You should try getting insurance to cover a homebirth, it’s awful. I really don’t see why they’d rather pay ten thousand dollars or more for a hospital birth instead of the 4,000 my midwife charged.

    Insurance companies are the worst. I’m planning on unassissted pregnancies and births for the next children to thankfully it won’t be a problem.

    Good luck!!

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