Thursday, June 19, 2008

Insurance faux pas

So, I was reading tonight a blurb from an online aquaintence regarding a letter she recieved in the mail today. June 19th.... JUNE. She was diagnosed with breast cancer 6 months ago and has been through chemotherapy and had both of her breasts removed and today she got a letter from the facility she had a mammogram at in JANUARY letting her know that her test was abnormal and she should come in for further testing. She found it hilarious.

It reminded me of a couple notices we got from our insurance company when Alex was sick. The night Alex was born he was transported by ambulance 100+ miles to a hospital with a NICU where a plan of action was made while he was stabalized. 2 days later he was flown via hospital plane to the University of MN for further treatment to save his life. At this time a tiny syringe and a ventilator were keeping him alive.

A couple weeks later, while living in a tiny room at the Ronald McDonald House we received a letter from our insurance company. The letter stated that they would be denying coverage for Alexander's flight because it was not "pre- approved" and "non emergent". Because you know we always charter private jets to get around. Not even a medical helicopter is good enough for people of our stature, it must be a private plane with a NICU team aboard. Apparently I should have called my insurance company before I gave birth and notified them that I intended to have a baby and that sometimes things go wrong so could we just pre-approve everything that might happen now? Maybe we could just pre-approve everything that could possibly happen to me or one of my family members in our lifetimes, then we will be covered. Ok?

Then upon Alex's 2nd surgery at 8 days old the little unfortunate soul somehow ended up with a splenic rupture. The doc was in the OR for hours replacing blood loss and trying to get it to clot up, what with all the heparin they were pumping into the kid.

My insurance company, not being one to miss a chance to bill someone else sent us a letter a couple weeks later asking if Alexander's spleen injury was a work related accident. No, I replied. We generally don't send our babies into the workforce at 8 days old, 10 maybe but not 8. Also, he most definitely would have taken the day off work that day, with having open heart surgery and all.

The third came a couple weeks after Alex died. Having heard that the boy had been stricken with a Cardiac arrest they quickly sent us brochures in the mail. Well, they sent Alex brochures, after all the envelope was addressed to him. Being his mother I figured it was ok to open his mail, fraud be damned. The ever so thoughtful insurance company, being very pro-active in preventative care sent 2 brochures to my son. 1 giving him tips on how to lower his cholesterol, the other entitled "How to avoid a second heart attack". Bless them.

Who can blame them, after all, they probably choked on the million dollar doctor bill the boy incurred and couldn't afford to pay attention.

Post a comment if you have a humorous (even if it wasn't at the time) insurance faux pas story!

4 comments:

Heather said...

We didn't have our own health insurance for our first pregnancy, so I qualified for pregnancy Medicaid. At 28 weeks, I was in the hospital for 3 days for pre-term labor. Then at 36 weeks, we discovered that she had died in utero (found out later that the cause was a cord accident). While was in the hospital recovering from the c-section, a medicaid case worker called to ask why I was in the hospital again.

I found it very ironic that I had to explain to a compete stranger over the phone that my baby had died. She was a bit speechless...

maryellenlewis said...

When my daughter was hospitalized with infantile botulism, my husband called to get permission for the hospital to buy a $50,000 drug for her. The insurance company had an answering machine on saying that they weren't open, please leave a message. We got a note from the doctor who said she needed this drug now, not Monday morning at 9am (it would be too late). The doctor wrote us a note saying that this drug was necessary and urgent. Fortunately, we never received a bill for this hospitalization.

Teesa69 said...

Two years after my son's skull reconstruction surgery, I received a bill for $5,000 for drill bits, saw blades and screws!! I had to call a ZILLION places and tried to get it through the insurance, but we had changed insurance companies. Come to find out that it was well past the time they should've billed the insurance and they had to write it off. Besides, the 'approved amount' for the original surgery was well over $500,000 (with all the surgeons and assitants involved plus three days in the hospital and all the stuff that goes with that. I guess it wasn't really an insurance faux pas? More of a hospital one?

dorannmwin said...

After I went to the hospital for my miscarriage, a few weeks later, I got a packet in the mail with a pregnancy journal and planning prenatal care pamphlets.
Now I find in humorous that insurance companies don't pay a bit of attention to the claims, but then, it did nothing but put me down in the dumps again.