Health and Fitness Articles

Posts Tagged ‘Premature’

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.

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.

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.

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, 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.

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.

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 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.

Luckily, the insurance company has people in it that also see the problems in the system and are trying to help. The key is to find those people and ask if they will personally help you in all your claims for the future. Get their personal extensions and emails so that you don’t have to deal with the phone center customer service know-nothings that will just hand you the standardized statements of policy. I have found this to be useful.

Remember that you are a client with rights, and you can question or appeal anything that you see going on that doesn’t seem right. Contacting the insurance company before you pay the bills when they come will prevent overpaying bills that the insurance may still be working on. Doctor’s offices also sometimes will continue charging you the full bill even after the insurance has made deals with them for a lower price, and you should be aware is this is happening. Even writing down conversations you have with the insurance will benefit if any miscommunications arise, so you can verify 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.