changing lives since 2003 (ms_pooka) wrote,
changing lives since 2003
ms_pooka

a long, hard, slow screw

... is what i’ve just finished receiving from my OB’s billing department. i think today we reached the climax just before they hopped out of bed and told me at gunpoint to leave all my money on the table.

after my second visit with a doctor, i went to pay my bill and was informed the billing department had finally received confirmation they carry my plan. bravo. maybe not the best rates ever, but i wasn’t willing to marry early just to get a discount on my baby.

i received a letter from humana dated nov 17 explaining that an appeal on a claim i assume was made by a doctor showed that the doctors’ were, in fact, out of network.

i call humana. i call the billing department. i call my HR rep. my HR rep calls humana. the billing department calls humana.

the billing department tells me that humana tells them that my plan only covers physicians in houston.

the HR rep tells me that humana tells her that there just aren’t any OB’s within 75 miles of my address and that i should send a letter of exception to humana to ask them to give me in-network rates for my current group of OB’s.

two days after faxing and emailing the letter, humana tells me to wait up to 30 days for their decision.

last friday, i received a letter from humana dated january 6 telling me that they cannot pay out-of-network doctors at the higher level of benefits because they found two OB/GYN’s in my area. two OB/GYN’s i don’t know from adam they found halfway through a pregnancy i’ve already paid $1200 on, but that’s neither here nor there.

i call humana to give them what for for stringing me along by telling me i was with in-network providers. i’m eventually told that the doctors’ billing department still couldn’t verify if they carried my plan as of their last contact with humana as they had been quoted both rates. humana remain hesitant to cast blame.

i leave a message for the billing department.

this morning, i receive a call from the billing department informing me that they are aware they don’t carry my plan. she asks who told me they do. i tell her we were told that on our second visit with a doctor. i forget to include that she had also told me this herself at the end of december. she tells me they have been waiting for word from some mysterious man in some mysterious non-humana department to find out if they will carry the plan.

i attempt several times to make her understand how it’s fucked up that they will still require me to pay inflated rates because they lied to me. she doesn’t seem to care or understand i’m not expecting humana to do anything about it. she can’t tell me if they will carry the plan or how long it will take to find out because of the mysterious man she contacted on dec 27 (mmhmm... around the time i informed her of the error initially) and hasn’t heard back. apparently the mysterious man does not have a phone. i ask if she can let me know what she finds out should the mysterious man ever contact her. i try very hard not to cry on the phone.

i get off the phone, crawl between my cats on the bed, slide my arm under ttyki, and cry a lot.

since the billing dept contact was unsure if dr. roland black (OB numbered one of two on my list from humana) was even an OB, i call the office of dr. roland black to learn that he no longer sees patients. he assists surgically.

with this interesting bit of misinformation tucked snugly under my re-fastened belt, i contact the office of dr. jonathan oh and am informed that dr. jonathan oh is an oncologist... hardly the man i want delivering my baby. even if i do receive a better rate.

i call humana. i tell him my protracted story. he puts me on hold. he takes me off hold to suggest i write a letter of... “a letter of exception?” i ask. why yes. i remind him that’s how i got to this point in the first place. i’m informed the department of Grievances&Appeals does not accept phone calls and i will simply have to wait another possible 30 days to hear from them again regardless of the fact that i’m halfway through my pregnancy and losing more and more time to decide if i should “marry” my boyfriend for the money even though they are the ones who screwed up the last round.

you know what's funny? my deductible is so high in-network ($1500/year) that i'm not even convinced it makes all that much a difference. but who knows? insurance math is some kind of mystical science not meant for the masses to have access to.
Tags: insurance
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