Insurance Customer Service
Nothing compares to having your first child and sharing in all the joy that comes with it, that is nothing except starting your dealings with the insurance company. In the cases of premature babies, the last thing on your mind in the payment of medical bills. Regardless, let me share with you what comedy has occurred since we have began our relationship with our insurance policy.
My son had to be quickly taken to another hospital when he was born that had an equipped NICU, and the bill to make this little drive was the first to arrive. The insurance had denied payment on this $1,000 because they didn't see it as a medical necessity. The only thing I could think of was that they expected us to try and plug the incubator in our car's cigarette lighter. We wrote an appeal, that has now made it covered.
Since we are students on the university plan, we are required to first see our on campus health center for all our doctor's needs. My son was born in a different state, and so it really wasn't an option to go to their health center. Perhaps we could have flown our son to the health center for all his many doctor's appointments, but even that would have been more expensive than the doctor's bills we now have to pay out of pocket for because he wasn't treated at the health center.
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, I asked the insurance company if they ever actually communicate with the health center before they write their policies. So you understand that we are paying out of our pocket because we didn't go where the insurance wanted us to go get his shots, when they don't even give shots anyway. Are you appreciating the hilarity of this ignorance? I hope so.
The mother of all our bills came from the doctors at the NICU that daily visited my son in the hospital. Let me first clarify that when my son was first admitted into the hospital, we called the insurance to make sure that this was ok and everything would be taken cared for. Regardless of their reassurance, the bill came stating our insurance's lack of coverage.
Apparently they cover the hospital, but not the doctors that work there. Because it is an option to go to the hospital without seeing a doctor. That totally defeats the purpose of going to the hospital doesn't it? So, I'm at a loss to how this policy 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'm assuming that there is a man somewhere in the depths of the insurance company who makes his living out of writing confusing no nonsense policies about receiving medical treatment when he himself has probably never been to the doctor. Apparently when you work with insurance you are miraculous free from any kind of medical attention, or else they would be most astute at making it easier to use their policies. I wonder why it was such a topic of debate at the 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.
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.
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.
US $5.10
