Monday, October 19, 2009

Walk a day in my shoes

When you have a special needs child, especially one that has lots of medical needs - nobody tells you how hard it's going to be, and just how many battles you will face daily. Battles with your emotional state, battle with dreams you had for your child now lost, battles with the state agencies to get your child services, battles with therapists to provide the best possible care needed for your child to push them toward progress, and the never-ending battles with your insurance company and the vendors they don't pay on time... leading to battles with credit agencies over your insurance company's mistakes that have lead you to this situation.

Last week and this week I am working on clearing up some medical bills. I only do this about once a quarter, because I just can't live my life being that angry all the time. Why would I be angry? Below was the scenario to clear up ONE single medical bill that was not paid by insurance and turned over to the collection agency for reporting... here we go:

1. Call the insurance company (let's call them UHC to shorten the typing here) to see why this vendor's bill had not been paid.
UHC says they don't see that this was ever filed with them.
I say the vendor's statement shows it was denied by them and gave them the dates.
I am told that this does not exist in UHC's system - and I am going to have to call the vendor to get them to send it in for payment.
(35 minute phone call)

2. I call the vendor who tells me what is on the statement is accurate and they reaffirm that UHC denied the bill.
I am told I need to call UHC back and should probably ask for a supervisor.
(25 minute phone call)

3. I call UHC back and they once again tell me they can't find it in their system. I ask for a supervisor.(This happens A LOT, so you can sense my building frustration and anger - I mean - hello - do you people know how to access your own system??)
They find it in the system and that it was denied. They tell me they can put it through for payment again, and the process will take about 10 days.
I said I've already been sent to collections on it because this was supposed to be paid by UHC already and I want to speak to another supervisor.
Next supervisor says yes, it should have been paid and the denial reasons in the system don't make sense. He tells me it will be put in rapid review and someone will call me back in 48 hours.
I ask for another supervisor, because I don't have 48 hours, I am in collections over your mistakes.
Next level supervisor approves payment of the bill, after I walk him through the reasons it shouldn't have been denied in the first place, and says a check will be to my vendor in 10 days.
(Phone call takes 75 minutes to complete)

3. I call the vendor back with all the information about how this bill will be paid and their check has already been approved. They notate my account and tell me I need to call the credit agency myself. But when they get paid, they will notify the agency.
(phone call takes 20 minutes to complete)

4. I call the credit agency to alert them that this bill will be paid to the vendor. They say they will notate my account, but the vendor must notify them before they will remove it from my credit report.
(phone call takes about 20 minutes)

So finally, after all this... I still have balls in the air I must come back to check on in 11 days with all parties to ensure payment has been made and it's been removed from my credit.

People - I want you to remember one thing here - this was for ONE SINGLE medical bill!! It took 4 phone calls, and an hour and 35 minutes to TEMPORARILY get things in order on this ONE SINGLE medical bill.

Last week I had to process 6 medical bills, and have 3 more waiting for me this week.

I repeatedly tell the insurance company that this is undue stress on a family that's obviously already so taxed financially and emotionally and that this is not right. I realize that I never talk to anyone who can actually do anything about it, but it does get me (eventually) to the right people who can at least do something about my account. I tell them that we don't put their monthly premiums into "review" at our house to determine if they get paid or not, and they shouldn't treat us like this when we pay our premiums always and on time - that they should not be putting this undue burden on us all the time and that they need to pay the things that our coverage outlines as covered. DANG IT!! (I'd like to use stronger language here to express my total frustration, but I hope that you can kind of get the picture and insight into this ridiculous circus we are made to play for EVERY BILL that comes in.)

I thank God that He provided me with a loving husband, who after seeing me go through this for over 3 years was actually in the room with me one day last fall when trying to handle one bill... and got nowhere on the phone after 3.5 hours... got his own upfront and personal front seat to what it's really like. He at least agreed to take over handling the rest of our finances. Now I handle medical, and he handles household. A true partnership - and I love him for it.

We did the VICTORY WALK for breast cancer at LSU this past Friday, so here are the pics from that. We walked in honor of my sister Shala - 3 time survivor of breast cancer. We are so blessed she is still in our lives and she is an inspiration to all of us to never quit fighting and never give up. I'm surrounded by people of miraculous strength. My mother by all accounts barely made it here - as a baby had a complete blood transfusion and they didn't really know if she was alive or comatose for about 10 days until she wiggled her big toe! And I don't have to tell you what a fighter my son is. And you wonder where I get it from...

Working on filling all those orders for the fundraiser - thanks everyone for your support!!

Braden, Kodi & Brad


shalamarie said...

We all love you. Your are an inspiration to all of us. Keep your chin up and look above. We love you- S & P

General 5A Pigott said...

That's amazing Kodi! That boy looks more and more like Brad every time I look at him! He REALLY is a Mini Me!

Christine said...

You are an awesome Mama. We just adopted our son with spina bifida and it has been quite the journey. Thanks for sharing your blog with the world.

Christine said...

You are an amazing woman. I can feel your frustration about the insurance company-- I have battled similarly. We all have our frustrations--- don't ever wonder if you are the only one. Have a great day!

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