Thursday, October 05, 2006

Insurance fun

Wanna feel frustrated along with us?
With Julie, really, because she is the saint dealing with people on the phone.
This one will be especially fun for our European friends. A vision of what is to happen with your healthcare system.
We are lucky enough to have health insurance. We “only” need to make sure that the treatment we seek is within the system. Or comes from someone who works with our particular insurance carrier.
So far, no problem. Right? The insurance has an outdated list on their website, but we know enough to call to double-check.
When we get a bill, we get a little concerned, but figure there’s some mistake we can clear up.
So, for example, when we got a bill for something done at the hospital, which the hospital billed from an address that wasn’t in our insurance carrier’s database. The hospital covers a city block and I guess the insurance only has an address for one of the four streets that border it. When the hospital bills from another street, it appears as “out of network.”
Okay. Next joy: we get a bill for Coco’s neurologist. We, of course, figure (because we’re not too happy with the way the office is run) that they changed their insurance alliance and didn’t bother to tell us. This happens more often than you might think, according to the insurance agent Julie spoke to today. But it hadn’t happened in our case. They misspelled the doctor’s name in their files, so the correct spelling showed up as “out of network.”
But the best one is to come, and we seem to be at the mercy of some bureaucratic imp. Coco’s neurologist (in the network) has Coco take blood tests. We go to the hospital next door (in the network). There, we sign in and go to a blood-taking lab (in the network). Cool so far. They send the blood out to a lab. But here’s the kicker. They arbitrarily send it out to one of SEVERAL labs, some of which are in the network, and some of which are not. So, for the exact same blood-test at the exact same place using the exact same procedure, we might get billed or we might not.
So, of course, we’ve gotten some bills. AAAAARGH!
What’s next? The hospital orders food from a place that accepts our insurance but drinks from a place that doesn’t, so the drinks show up extra on a bill for a hospital stay.
But no, that would be straightforward. The lab-technician costs seem to be tied in with whoever analyses the blood and we get billed for that or not, depending on who touched the blood.
In the scenario we’re experiencing, the whole hospital stay would be billed to us because the drink distributor didn’t accept our insurance carrier.

1 comment:

green clementine said...

I wish the French knew just HOW LUCKY they are! The health system over there is really good. For how long yet?