Three Vultures Collaborate
The various vultures of this world work so hard at ripping my flesh off that I occasionally have to dedicate an entire day to beating them back with a stick. Today is turning out to be one of those days.
My insurance company still hasn't paid a claim that was filed in February. I had a pap smear. They say they're not paying it because I have a pre-existing condition. I had a pap smear. That's the only thing on the claim. It's a routine annual exam. Having a vagina is like having a car-- you have to take it in for an oil change every 3000 miles. It's in the manual. So I have been trying to explain to them that unless having a vagina counts as a pre-existing condition, their reason for denying the claim is bunk.
Of course you can never solve a problem by talking to one person, or one vulture entity. You have to talk to several different companies, piece the bullsh*t together, and try to figure out a solution on your own, since they can't manage it even though it's their 9 to 5 job, not yours.
So the first person I talked to at the insurance company sounded like a young girl. I was frustrated, because this is the third time I've had to call them about this, and I've done everything they've asked me to do and they're still not paying the claim. After ten minutes of listening to b.s., I raised my voice slightly and told the girl that they were just giving me the same excuse over and over again. She decided to put me in my place. This pisses me off-- when some little girl in some nothing job decides that she's gonna flex her muscles and put me in my place. First of all, you don't yell at me, Little Girl says firmly. For the record, I didn't yell at her at all. I barely raised my voice, and only raised it after five minutes of trying to explain something to her that should have been on her computer screen in black and white. Basically the don't yell at me thing is just another avoidance tactic that they're trained to use, in my opinion, so as soon as they use it on me I just say, Your supervisor, please.
Her supervisor was only slightly less mentally challenged than she was, but at least she understood what I was saying, even though the solution was a non-solution.
After that, I had to call vulture number two-- the doctor's office. They have been told three times to re-file the claim with a different code. They claim they've done it all three times, but the insurance company says they're not getting it. My biggest question is this: Why the hell am I the one who has to run back and forth between the two? I don't understand what either one is doing, and making me the go-between girl only further complicates and confuses the matter. The doctor's office files the claim with the insurance company, so why can't the insurance company call them if there's a problem? Because of the fine print that says I'm responsible for the charges if I can't find my way through the bureaucratic kudzu maze, that's why. They've got every reason to make it complicated-- because if I get frustrated and decide to "just pay it," they win. And the doctor's office could care less who pays, as long as someone pays, so they have no reason to help me out. They're all working together to rip me off, I tell ya.
There's a third vulture in this clusterf*ck, and that's Forrest General Hospital. I don't even know why the hell they're the ones sending me the bill and threatening me. They are the employer. The doctor I saw isn't even through them. He's in a separate organization across the street. They do work with that organization (Forrest General makes sure they get lots of business by requiring all of their employees to use them), but if I owe anyone money, shouldn't it be the doctor who saw me?
I'll admit I'm confused-- they've successfully made my eyes cross. But they will NOT get me to just pay it. I've been known to fight this kind of bunk for years. I even win one every once in a while.
My insurance company still hasn't paid a claim that was filed in February. I had a pap smear. They say they're not paying it because I have a pre-existing condition. I had a pap smear. That's the only thing on the claim. It's a routine annual exam. Having a vagina is like having a car-- you have to take it in for an oil change every 3000 miles. It's in the manual. So I have been trying to explain to them that unless having a vagina counts as a pre-existing condition, their reason for denying the claim is bunk.
Of course you can never solve a problem by talking to one person, or one vulture entity. You have to talk to several different companies, piece the bullsh*t together, and try to figure out a solution on your own, since they can't manage it even though it's their 9 to 5 job, not yours.
So the first person I talked to at the insurance company sounded like a young girl. I was frustrated, because this is the third time I've had to call them about this, and I've done everything they've asked me to do and they're still not paying the claim. After ten minutes of listening to b.s., I raised my voice slightly and told the girl that they were just giving me the same excuse over and over again. She decided to put me in my place. This pisses me off-- when some little girl in some nothing job decides that she's gonna flex her muscles and put me in my place. First of all, you don't yell at me, Little Girl says firmly. For the record, I didn't yell at her at all. I barely raised my voice, and only raised it after five minutes of trying to explain something to her that should have been on her computer screen in black and white. Basically the don't yell at me thing is just another avoidance tactic that they're trained to use, in my opinion, so as soon as they use it on me I just say, Your supervisor, please.
Her supervisor was only slightly less mentally challenged than she was, but at least she understood what I was saying, even though the solution was a non-solution.
After that, I had to call vulture number two-- the doctor's office. They have been told three times to re-file the claim with a different code. They claim they've done it all three times, but the insurance company says they're not getting it. My biggest question is this: Why the hell am I the one who has to run back and forth between the two? I don't understand what either one is doing, and making me the go-between girl only further complicates and confuses the matter. The doctor's office files the claim with the insurance company, so why can't the insurance company call them if there's a problem? Because of the fine print that says I'm responsible for the charges if I can't find my way through the bureaucratic kudzu maze, that's why. They've got every reason to make it complicated-- because if I get frustrated and decide to "just pay it," they win. And the doctor's office could care less who pays, as long as someone pays, so they have no reason to help me out. They're all working together to rip me off, I tell ya.
There's a third vulture in this clusterf*ck, and that's Forrest General Hospital. I don't even know why the hell they're the ones sending me the bill and threatening me. They are the employer. The doctor I saw isn't even through them. He's in a separate organization across the street. They do work with that organization (Forrest General makes sure they get lots of business by requiring all of their employees to use them), but if I owe anyone money, shouldn't it be the doctor who saw me?
I'll admit I'm confused-- they've successfully made my eyes cross. But they will NOT get me to just pay it. I've been known to fight this kind of bunk for years. I even win one every once in a while.
Labels: Bureaucratic Incompetence, professional screw-ups, stupid people
You go girl!! I am a little concerned about our move to Florida this summer. We have had an HMO here in California FOREVER and we have been very happy with them! None of that BS that you are going through. It seems through our research that we will not be set up so good and that worries me. I can't believe they are not paying for the pap.... that seems bizarre.... good luck!!
Posted by
Anonymous |
4:06 PM
The reason the bill comes from Forrest General, I think (what I have learned from my own experience with them), is because Forrest General and Hattiesburg Clinic are basically the same place and that is who pays the doctor. But this is not the case if you go to the Emergency Room, those doctors bill from someone else. It can be very confusing and it does not seem right, I wish I could be of more help.
Posted by
Anonymous |
4:52 PM
faithram-- I found out that FGH did the lab work. It was supposedly going to save me money to let them do it since my spouse works there. That doesn't explain the $490 bill very well, but whatever.
Posted by
Mommy Needs a Xanax |
12:22 PM
My sister had to do the same thing with her insurance company - played go-between the dr and them, had to relay the code for them. It's ridiculous. Guess I might be okay that I have no insurance and use the tribal clinic. It's substandard care, but no hassling with insurance companies, lol.
Posted by
Redneck Diva |
3:58 PM