20 February 2010

Incompetence is NOT An Art Form!

Mood: Frustrated (seriously. frustrated)

What I'm Watching: The Olympics (cross country skiing anyone?)

I'm grateful that I'm lucky enough to have insurance. Really. I am. For many years I wasn't so lucky. I worked hard but worked for places that didn't offer insurance and I couldn't afford to get any on my own. A major surgery and a bill to the tune of $30,000 makes one extremely grateful for a job where insurance is provided.*

BUT. (and you knew there had to be a but, right?) Is it really necessary for insurance companies to raise incompetence to an art form? For example, last year I had some symptoms that required some further investigation in the form of a medical procedure. After the procedure was completed, I received a letter from the insurance company asking for more information b/c they were concerned that the procedure was for a pre-existing condition. Huh? So, I called the insurance co. and asked some questions. The conversation went like this (cliff notes):

Me: I have a note here asking about pre-existing conditions associated w/ this procedure but it only gives me a code for the condition. What does the code mean?
Ins. Rep: Well, I can't tell you that because it would be a violation of your privacy.
Me: But I've already given you my name, date of birth, SS# and my account number. You've verified my identity.
Ins. Rep: I know, but I still can't tell you what the code means.
Me: But, you need to know if this code was a pre-existing condition?
Ins. Rep: Yes.
Me: And you need me to tell you if the code is a pre-existing condition?
Ins. Rep: Yes.
Me: But you can't tell me what the code means?
Ins. Rep: No
Me: (heavy sigh) you don't see the problem here?

Lather, rinse and repeat this conversation many times over the next few weeks until finally an ins. rep is able to tell me that they've received all the information they need from my doctor and I'm good to go. So, while I still don't know if I have the mystery pre-existing condition, the insurance company assures me that the claim will be processed and all will be well. Yay! Birds are singing, bells are ringing, deer are frolicking in the fields and all is well.

Until last month when I received a nasty collections notice from the hospital. Seems the bill hasn't been paid and now they want it paid in full or they're going to send me to collections...words like ruined credit rating and garnished wages are thrown about and I'm confused as to why the bill is A. so stinking high and B. so freaking late. If someone owed me money like that, I might not wait a year before billing them. Just sayin...

Sigh. I call the insurance company and am told that the claim hasn't been processed yet because they haven't received all the necessary information from the hospital. What?!? Sigh again, louder, longer, and with swearing this time!

So, to the hospital? The sharpest end of a pointy stick! If you can't provide the insurance company with the required information, how can you expect to be paid in a timely manner?!?

And to the insurance company? Really? Incompetence is not something to which you should aspire and maybe your job interviewing process should involve a little something more than just shoving a mirror under someone's nose just to ensure that they are, in fact, breathing!!!!**

*BTW, the hospital? Wanted that $30,000 paid in 90 days. According to them, the fact that I only made about $12,000 a year at the time should not have presented an issue. Morons.

**obviously, I don't know that this is the exact requirement for employment in the insurance industry. I'm sure that there are many fine, intelligent people who work in insurance...I'd just like to actually talk to a few of them, it would do wonders for my stress level.



  1. I am SO for the healthcare reform. This type of idiocy is absolutely ridiculous. I'm so sorry for you having to go through this.

  2. I agree...obviously the current system isn't working so well. If this whole thing weren't so stressful it would be too funny for words. I just hope they manage to get it sorted before I pull all my hair out! :)

  3. Ugh...lunatics. Truly. Broken little turkeys. Funny conversation, really, but what an awful experience all around. I really hope this all gets resolved.

    If it makes you feel any better, I left an award for you on my blog ;) Yeah, okay, I'm sure you'd rather just have the bill paid. I don't blame you.

  4. @Carol..it is really funny...I imagine that it will someday make its way into a story somewhere. What was even funnier was the fact that the insurance rep really couldn't see why I was frustrated.

    And squeeeee!!! An award does make me feel better!!!! :) I mean, sure, I want the bill paid but I'm being realistic here. If it's taken them a year to even figure out and let me know there's still an issue what are the odds of this thing getting sorted any time soon? Just sayin...

  5. Okay you got me started. Reminds me of when I was in a car accident. I was 4 months pregnant with Ryan. The insurance refused to cover any costs for his delivery and the delivery of Drake because both were considered a result of the car accident I was in. After going round and round for a very long time with different people at the insurance company, if finally said "listen I want to talk to someone with a bit of intellegence I hope that would be your supervisor if not I will go to the top." I get on the phone with the supervisor and explained about the accident. I then explained that the bills are for childbirth not one but two and they were born almost a year apart. Know I now that crazy people do crazy things but getting pregnant in a car accident and having two kids a year apart is just not possible" The supervisor started laughing. I was like stop laughing I have tried to explain this to numerous costumer noservice people who just do not understand the difference between a car accident and pregnancy/childbirth. She apoligized and took care of everything.

  6. Also St Francis policy is that the bill is paid in full in 30 days or you sent to collections. Just the device that was implanted in his heart was $47,000.00 dollars. Our share of that was $9,400.00. And we have good insurance. At that same time we also had bills for 3 doctors during the surgery. The operating room and all those expenses, post op in picu over night. Sometimes bills have to go to collection. No it is not suppose to ruin your credit if it is medical. I am not sure if they can get a judgement for your wages, but you would go to court first and a judge would need to review everything. I don't think a judge would allow a judgement against your wages since the hospital messed up givinf insurance the needed info.

  7. sorry for the typos. I was in a hurry and did not reread before posting.

  8. Aunt Kay, I totally remember you going through that when you were pregnant with Ryan. Stupid, stupid insurance people. *sharp pointy stick to them too!*

    St. Francis and St. James are all in the same OSF circle and, when it comes to billing and collections, they're pure evil. They have very little (read: NO) tolerance for the fact that the average family doesn't have an extra $10,000 laying around to fork out on medical bills. So frustrating!!!

  9. I wonder if I will get a bill for Drakes surgery on the 15th. This will be the first time with anything major since Drake getting the medicaid card. Should be interesting to see what happens with the billing. The last time I had him down there they were so kind as to offer to take my credit card information so that we would not have to be bothered with the bill. I was like mmmm thanks but no thanks. Bill my insurance and then you can bill me the remainder. I asked if there were really people out ther that would give them there credit card info before any procedure was done and without seeing an itemized bill. They assured me that a lot of people do that and find it so much less stressful knowing that the bill was taken care of already.

  10. You should be fine w/ his card. They're usually pretty good about picking everything up. And sure, let me just blindly hand over my credit card and let you charge whatever you'd like...it would really make me feel a whole lot better. Riiiiggghhhhttt.

    That would be like going into Wal-Mart, telling the cashier that you need some stuff and handing her your credit card and saying "charge me what you want for whatever you give me". Morons!


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