Tuesday, October 14, 2008

i have had enough!

i just can't help feeling like this whole mess with the insurance company is NOT my fault -even though it very likely is.

let me start at the beginning. i will try and keep it short and as nonboring as possible.

when we moved here i started going to a clinic. i had heard good things about them from folks i worked with. the insurance covered said clinic. so i picked a PCP and off i go for a visit.

the dr i picked for my PCP got harder and harder to get in to see right after i became her patient. i went for one visit. ONE!(this was several years ago now) and after that she dropped back to working part time. every time i called for an appt it was like a month before she could see me - for ANYTHING! so i always ended up going to see a certain other dr.

i called the insurance company about changing my PCP to the other dr i was always going to see and they said "as long as that clinic files their insurance as a group you can see any dr there without any problems." so i continue going to see the new dr there and have had no issues with insurance claims or anything.

until now.

when i went in in september it all surfaced!

my original PCP had retired. so to the insurance company i was doctor-less. so when the bill went to them along with me lovely referral for prenatal care it was all kicked back.
i tried and tried to explain to the insurance that i had been going to this particular dr for 3 yrs and i was not a new patient. but to them -and to their damn computers - i was.

i guess the issues was that even though i was seeing a different dr than my original PCP that i could never get in to see ,all of my insurance claims were filed under theoriginal pcp's tax id #. so here i go to get a pregnancy test - a $165.00 pregnancy test! - and now i have to foot the bill for it?? even though she's been my dr for how long??

i called the insurance company to see if they were going to pay it and the lady tells me that my new dr -who really isn't my new dr to anyone but their computers- was only my dr as of sept 15th of this year. my office visit was for sept 9th. so even though i went in on the 9th and they submitted a referral on that same day for prenatal care they didn't get the request to have my pcp changed to my NEW/OLD dr until the 15th -when we found out the referral had been kicked out due to being submitted by a dr other than my pcp -even though i'd been seeing her for years.

are you following me here?

so i called the clinic and left a message with the nice woman at the referral desk to see if there was another way around this.
i also called the insurance ppl and left a message with the supervisor that was helping me get my pcp changed in the first place.

i just want to scream!
maybe i'll call the billing department at the clinic and see if they have any brilliant ideas.

stupid stupid stupid.

on the bright side:
i was able to drink coffee this morning! i
have missed my coffee! the sight and the smell of it have repulsed me for so long!since the day i got pregnant pretty much.
and then yesterday i see it!
in the refrigerated section at the grocery store!
my beloved limited edition international delight pumpkin spice coffee creamer!
you can only get around the fall/winter holidays.
and it finally comes in a normal sized BIG 32 oz bottle!
for years i have had to by small bottles of it.(i think about half the size or a normal flavor) i'd buy 5 or 6 bottles at a time and stick them in the freezer. i'd stock pile enough to get me at least thru the spring. it's the best stuff!
so whether i could stand it or not i was having a cup of coffee this morning.
and it was lovely!!!

2 comments:

Anonymous said...

LOL!

"It's the MOST won-der-ful TIME of the YEAR...!"

Cupcake Blonde said...

This have just increased my loathing for insurance companies. Seriously, the make it impossible for us to get the health car we need. I am so angry FOR you!!