August 17, 2007
The ins and outs of our healthcare system
I can't remember if I have written about this (and I'm too lazy to look, so please feel free to drift if I am boring the pants off of you...), but I've been waging quite the little cold war with my insurance company, my doctor's office, and our local hospital.

When we brought H2 home, we had to have a whole slew of tests run to make sure all his vaccinations took and he didn't have some dreadful disease we needed to treat. And by slew, I mean our doctor's office sent us to the hospital, where they could take more blood from the poor little guy. And the hospital made us come back 2 more times so they could take more blood from the poor little guy. I won't even go into the poor little mama.... (in a very lucky stroke for me, the first trip so upset him that they were able to take his diaper samples right there and I didn't have to be involved in that collection at all... whew!).

All of the tests came back good, not that we were that concerned. H2 had excellent care under a doctor who attended Baylor, of all places, whilst he was in his homeland. But I digress.

Our bill, that's what I really want to talk about. Our insurance paid our well visit to see the doctor. And then they paid not. one. single. dime. to the hospital for all of their lab work. Did I mention that the lab work cost over $1600?

I called the insurance company, who told me that they could probably pay it under our plan, but not the way it was currently coded. No, they couldn't tell me how to code it. They don't advise on codes. They suggested I call the hospital.

I called the hospital, who advised me that only the doctor ordering tests can change a medical billing code. I would need to call the doctor's office and have them change it and send a new copy of the order to the hospital.

I called the doctor's office, who guffawed the stupidity of the hospital and promised to change it.

And then I waited.

And then I started getting daily calls from the "business office" of the hospital, which really isn't the business office at all, but an off-site collection agency. I'm quite sure that they have a note in my file stating that I'm snarky and they hate me. I don't much care.

Over the next weeks, the hospital didn't get the change, the doctor's office faxed it, they called, they told me it was done. I was in a constant state of waiting for either the doctor's office or the real business office to call me back.

I continued my daily pleasant conversations with folks from the "business office."

I kept calling the real business, to no avail. They couldn't do anything, my doctor's office couldn't do anything, and my insurance agency sure as heck wasn't doing anything. I finally told the business office to call my doctor's office if they wanted to get paid. I was tired of being the middle man.

I was irritated with our insurance company, so I wrote a letter. There's something in your insurance handbook about how to file an argument if a claim is denied. Since I was feeling pretty dang argumentative by this time, I didn't have much trouble putting my feelings down on paper. My letter went something like this:

Dear Slush's Insurance Company,

We recently adopted an adorable baby boy from Guatemala. Upon our return to the United States, we proceeded to take our new son to the doctor. Our doctor ordered a range of recommended tests to make sure all of his vaccinations were up to date and had taken. We felt this was prudent not only because it would save you the money of re-doing 7 months worth of vaccinations, but because it also saved him the trauma of more shots. We feel being taken to a new home is trauma enough for one tiny baby. We would certainly hate to have to use some of our mental health benefits because we gave our baby so many shots. However, it is apparent from your refusal to pay our insurance claims that you disagree. It seems you would pay for new vaccinations, but not blood work.

We feel this is unfair. We have saved you quite a bit of money in our pursuit of international adoption. Perhaps you don't realize this. We could have had another biological child and cost you much more money. In 2004 dollars, our birthing/ hospital experience alone cost over $15,000 (Slush is a guaranteed c-section, as our local hospital does not do vbacs). And yet you refuse to pay a measly $1600 after all we have done for you? Where is the love?

L and Slush

I waited some more. My breath caught in my throat each day as I opened the mailbox and saw a letter from our insurance company (we get daily mail from them as well as Chase).

Finally, we got a response. Account paid, minus the rest of our deductible. We owe only $200 of the $1600.

And now my friends, we do the dance of the joy. I sure will miss my friends at the business office.

Here is our picture from court this morning, where the state recognized our foreign adoption and we changed H2's name (not to WuggyPants, much to Hatchling's disappointment. Don't ask me why, but that's honestly what he wanted it to be...)

And here's one of me, H2, and my mom tonight at the fair (H1 was riding the dragon roller coaster). I got my hair cut, but I don't know if you can really tell that much how it looks. I like it. L is resigned (he's moved from saying "it will probably be ok" when I got home to thinking it's alright if I must have short hair, though he doesn't understand why girls do so much to make themselves look pretty and then go and negate it by cutting their hair all off...)

I think we should change this one's name to WuggyPants...

Blogger Hillary said...
OK. First things first. GO YOU! Ms Feisty herself! Humour and logic, with a hint of ticked off... it'll get 'em every time.

Second. WuggyPants. Best name ever. I think I'll name my first child that. ... or maybe not. But still a very cute nickname!

Third. NEGATE IT? You look GREAT with short hair! Phooey to him! ;)

Fourth. Oh. My. Goodness. That photo of H1 is SPECTACULAR. What a great capture of that moment! It sooo makes me want to be a kid again!

Have a happy day! :D

Blogger Amy said...
My niece wanted to name my nephew "Froggy". It just meant that we've bought him oddles of frogs in his 6 years of life. "WuggyPants" totally rocks, though. I think Hatchling is onto something.

The hair? Rocks.

The pics of the littles? ROCK!

Blogger Jill said...
Fabulous hair! Been thinking of about that same do, except with bangs. Looks great on you.

I must have missed the fair. Of course, I am not the least bit thrilled about being out in this heat.

Will you be at the consignment sale tonight? I'm going with a Mom-to-Be pass. I'll be one of the ones with a monster belly sticking out way in front of me. :) Oh yeah, and my 3 year old daughter because my husband conveniently forgot to tell me that he already had a golf game planned with some buddies. When does that ever happen? Only times when I have something else planned. Oh well.