Insurance Customer Service
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.
Especially in the topic of immunizations, we needed to get them at the pediatrician’s office. Then we were told they weren’t covered because they weren’t given at the on campus health center. So, now we have moved back on campus and I took my son to the school health center for him to get updated on his shots. Would you believe that they don’t even give immunizations at the health center?
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.
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?
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 naturally being appealed for the lack of sense it makes along with the lack of options we had once he was admitted into the hospital. Especially since I was still in the hospital when he was admitted. A small band was put on his ankle as a safety precaution that kept us or anyone else from taking the baby even to the elevators. Aside from those excuses, we wanted the best care our three pound son who needed help with the simple task of breathing without having a second thought about what the insurance was going to do.
The insurance company must employ a man somewhere in their crevices that has never been to the doctor in his life, and he is the one assigned to write the policies of how it is to be done. It seems that all the employees at these companies must miraculously be free from needing any sort of medical attention, or else they would be more aware of the problems that exist in their policy. No wonder it was frequently a topic of debate for 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.
