After 5 months, I received this piece of mail I had been waiting for and fighting for.
If you can't see what it says, it says "Patient Responsibility- $0.00"
Since Matt is self-employed, we are on a private health plan which doesn't give the greatest benefits, its more for catastrophic coverage. The maternity deductible was $5000. Ridiculous, I know. However, we wanted another baby, so we made it work. We did some finagling with Aflac and such, and had a pretty good financial plan worked out so we would end up only spending about $1200 out of pocket. Totally do-able. Well, my lovely insurance company pert near made me go crazy these last few months. They denied two of the biggest claims because there appeared to be complications, they said. We were going to have to be responsible for the $4700 + they were not going to cover. My labor and delivery had zero complications. I contracted and pushed, he came out and breathed, and we hung out for a couple days watching ABCFamily and TBS in the hospital. I couldn't think of what could have been considered a complication. I marched myself to the hospital to review the medical records. It clearly stated "NO complications" right at the top. My blood was boiling. So, after 3 billion phone calls to the insurance company and getting different answers every time I called, I got it an appeal in the works. After 3 billion more phone calls and a threat that I would get an attorney(ha ha like I would ever even know where to begin with that...), the appeal got approved and I received my long-awaited piece of mail. Seriously, 5 months later. At times, I about threw the towel in and paid the danged balance, but I was determined to win this because I know they were giving me the run-around. Lesson of the year--- don't give up when you know you are right. And I am ALWAYS right. JK
This guy would have been worth it no matter the outcome.
Monday, December 6, 2010
Persistence counts for something
Posted by Allie at 9:19 AM
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5 comments:
He sure is adorable! Hate all the insurance ridiculousness--but I'm SO glad your hard work paid off!! What a relief.
Insurance companys suck. We have been given the run around three times now- all with different answers. And just got another 2,000 bill- three months later. I am pretty sure they are evil. I am glad you got that worked out! I may have you call my company for me:)I recall you are very handy on the phone when someone needs a good talkin to!!!
What a pain! I am glad you got it figured out though, good for you.
I was talking to an insurance broker the other day who told me starting Jan 1, 2011 ALL insurance plans must cover maternity (including individual plans) due to some laws that are passing. So, maybe next time it won't be so awful! Here's hoping!
Don't even get me started with fighting with insurance companies. It is my second- no wait, first- job.
I freaking HATE insurance companies. We are looking into private insurance and I'm amazed at howo much the deductables are being that the premiums are outrageous as well. Good for you for getting through to them.
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