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Tuesday, August 11, 2009

Insurance (insert expletives here)

It's been over 2 months now since my permanent implant was "installed." As of last week, I hadn't seen the final bill yet. I shouldn't have to pay much since I believe I've reached my maximum out-of-pocket for this calendar year ($5,000). Thank goodness for caps on personal insurance expenditures. Anyway, on Thursday I get a call from the billing department of the hospital where the surgery was done. The lady tells me "you have a very large claim with us pending from June."

"Uh, yeah." (ingenious answer, I know.)

"Well your insurance refuses to pay it until they receive a 'Coordination of Benefits' form from you."

"I have no idea what that is."

"It's a piece of paper telling them that you don't have any other insurance coverage, so they are responsible for the entire claim. I tried to tell them that was the case but they won't listen to me. They said they sent you the form..."

"No, I haven't seen anything like that."

"Well, then we have a problem."

Fantastic. I nearly had a heart attack because the bill was $138,000. I don't have that kind of cash just lying around. In fact, I'm pretty sure I've never had that much cash in my life.

Fast forward to Saturday.

Lo and behold, what comes in the mail but the "Coordination of Benefits" form. All I had to do was check a box on there saying that I don't have any other insurance. Really? They couldn't call and ask me that? They couldn't fax me that? But either way, if they had talked to the lady at the hospital on Thursday, and I just got that in the mail on Saturday, I'm pretty sure they didn't even send it to me before they talked to her!

So, I called her back today, told her I had received the form, and put it back in the mail yesterday. Luckily she was very nice and said she'd just put a note on my file to wait on insurance a little longer.

Here's what gets me: part of the reason I spent four months in Chicago trying to get this figured out was becuase I was waiting on insurance approval for this procedure. Did they approve it and forget? Did they approve it and then decide it ended up costing too much? I really thought all this stuff was figured out months ago so it makes me angry to have to deal with it again.

And people think this country's healthcare system doesn't need a kick in the ass...