Wednesday, February 22, 2012

And then I almost died. The end

Things to NOT do on a Monday night: open any correspondence from the pediatricians' office.  Or any time really but we finally cleared out the mailbox after a week so in a fit of adultness (is too a word), I opened it.  And found a bill for $790 for Noelle's five year old well child checkup in January that the insurance company had declined to pay.  I believe that OMFG and WTFH were dropped.  (The kids were in bed.  My filter gets turned off at 8:30 pm. Compromise and all that.)

This could not be happening as we most assuredly do NOT have $790 available to pay said bill and OH MY FUCKING GOD, WHAT THE HELL?!  Fortunately I remembered that we had recently received an EOB from the insurance company that I hadn't opened yet but had filed with other paperwork.  (And by filed I mean put in a pile with other papers.  I've got this adult thing down cold.)  It was the explanation of what was owed ($790), discounts applied (none) and what we owed (nothing.)  Um, what?  So, the bill, which both parties agreed was $790, was not paid but we didn't owe.  Yeah, I got nothing.  So I called because that is what Responsible Adults do.  And after fighting with the voice activated system (with a pretty nasty cough so it gave up on me right quick) got through to an actual live person in less than 5 minutes.  (Key to customer service success: call after 8:30 pm apparently.  The more you know.)

I explained the situation and that we had recently began a new coverage, an open choice with a HSA.  My understanding (confirmed by the literature AND the representative visit to my building) was that annual check ups/well child exams were covered at 100% and everything else was as-is until we hit our deductible of $2700.  Trust me when I say that we would never have agreed to this plan had well child/adult visits not been exempted from this deductible.  It turns out that they didn't 'refuse' to pay, they were withholding payment until additional information was received.  What information you ask?  I'm so glad that you did for I shall tell you.  They wanted to know if we had any other medical/health insurance.  That was it.  No, no we don't.  All of our coverage is through my work.  They updated our information and gave me a confirmation number which I will provide to the pediatrician's office in the morning with the expectation that the bill will be paid, by the insurance, in 15 business days. 

Now once my head stopped spinning, the real magnitude of the episode hit me:  a single well child visit costs almost $800.  Think about that.  Eight. Hundred. Dollars.  Fortunately we have health coverage and pretty decent coverage but what about those who don't have that.  And I've always known that the insurance companies negotiate with the providers the amounts that will be paid but it was sobering seeing it in black and white.  The more that I think about it, the more that I am convinced that every person deserves health coverage.  The Republicans who are so fond of quoting the Bible when it's convenient for them seem to have missed the part where Jesus talks pretty clearly about helping one another and taking care of the poor and the sick in our midst.  It was kind of a theme of the entire book.  Good health shouldn't be reserved for only those who can afford it; I'm just thankful that we have options available to us but that is a topic I'll beat to death in another post.

1 comment:

  1. Oh, I think I would have had the same reaction, acronyms and all! (Although the way you describe it is a lot funnier.) When I had Sprite, the hospital I gave birth at had recently been bought out by another hospital, so their contract number changed. The day I gave birth. Imagine my surprise when a sleepless 2 weeks later, I received a bill for 11 thousand dollars due upon receipt. It took a phone call to clear it up, but my heart was in the throat for a bit there.


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