Wednesday, September 19, 2012

Insurance people stink!!

Thought I would take some time to write about our latest journey. Logan is scheduled for ear tubes, hydrocele repair, and an abr this morning. Part of me is like yeah, here we go again- these are just routine procedures. Then there's the part that is like every other mother out there freaks when their child is going under anesthesia for even one of these things and I'm really not super worried. So, I start questioning if I should be more worried. What I think it is, that we've done so many of these non invasive procedures, that I have almost become immune to the panic. As I am typing this at 4 in the morning I'm thinking, maybe I'm a little more stressed about it than I'm allowing myself to feel. I'm not even sure the lack of panic is because I know God is there taking care of my little guy. Yes, I know that He is there for Logan and have asked for prayers. I even explained to Jack that Logan was going to have surgery and that we should say a prayer for Logan. Of course all Jack heard in the whole conversation is, I get to go to Ms. Phyllis'. I'm glad I have a great neighbor that my kids love when it comes to this type of thing. So, this afternoon was spent on the phone with the insurance company. Apparently because the hospital moved and supposedly didn't tell the insurance company, Logan's appointment with the urologist was not fully covered. The reason this was a huge problem is because the urologist is part of the surgical team tomorrow and they were telling me he is out of network. What? So, I went to the ins. website found his name 10 times with 10 different addresses in their list of people that are in network. They said well with the address that he is claiming this under, he is not in network- all of a sudden it hit me, duh- the hospital moved addresses. So, then the person I was talking to said well you will have to file an appeal for this claim and you need to get pre-approval for tomorrow. So they forwarded me to the pre-approval lady who said, I don't know what the problem is- that dr. is right here in the system with that address- by this point I was probably giving a little attitude- I'd already spent quite a bit of time arguing with the other lady. So I asked the pre-approval person to tell the claims people where she found the docs info and she said well I can transfer you to them. I was like, NO, I am not going to discuss further about how they cannot find the docs name. While all this was going on, I had put a call into the dr. office because I thought maybe they could shed some light and umm we need to get this figured out before tomorrow. Finally hours later, after several messages left at the docs office, they said we already have the approval- like totally nonchalant. Ummm why then did I just spend the last 3 hours discussing with people who don't care about our situation and "can't help" us. And why couldn't someone at the desk tell me this instead of transferring me to the voicemail of the billing person. Ugh!!!! So, while this was going on I kept thinking, do we cancel all 3 procedures or just the urology part- It took 3 months to get all 3 docs on board to do the procedures on the same day and now you’re telling me one of them doesn't accept my ins. company. I was slightly freaking out- maybe more than I should have. Thank God, it is all resolved and yes the surgery will be covered tomorrow as in network. I really, really do not like insurance companies. The hundreds of people they employ to do "customer service" have NO customer service abilities. I think it's a rule that they are not allowed to "think". They have to follow the xyz script and well unfortunately the xyz script doesn't usually pertain to us. Thinking of the positive, I got 3 hours experience of standing up for my kid. The procedures.... Ear tubes-normal every day procedure. We are going to discuss the benefits/risks of the long lasting tubes before the procedure. I think Lo is on set 5 at this point. Hydrocele/hernia- I really don't care for the doc doing this procedure. Lo's had it done before, before he was mobile. Part of me doesn't know why we are putting Logan through this part because I believe there is like a 30% chance that it can come back. That is probably why we've procrastinated it over 2 years. The concern is that it would become herniated and then we would be doing emergency surgery. I was not told what recovery is, so after researching on my own (one of the worst things I can do sometimes) I'm realizing that Lo may be home from school for 10 days and not allowed to do physical activity for even longer. Ummm for his physical development and the physical therapy that doesn't sound too great. ABR- is a simple procedure but it takes so stinking long. This will be his 2nd ABR. I was reading about it again and thinking, oh I wish there was a way to get Logan to do a normal hearing test. He is so afraid of the hearing "booth" that we have yet to get any results. He was terrorized from the stuffed animals behind the glass- they don't even try to use those anymore, but it doesn't matter. He is afraid. Some things are behavioral with him, but the hearing test is not a "I don't want to do it and you can't make me do it situation" It's I'm terrified to go in there situation. I know how to cure the I don't want to with a little candy motivation. But, fear I don't know how to fix. We've tried lots of things. It shall be an eventful day of waiting. Tubes are like 10 minutes, Hydrocele repair is about 30 minutes, ABR is about 1 hour to 1 1/2 hours. Plus the getting him to sleep part and waking up. The urologist mentioned an overnight stay, but we shall see. Personally I'd rather go home. So, prayers that all goes as planned and that there are not complications from anesthesia and that recovery from hydrocele is really a piece of cake and I was reading wrong information. :)

1 comment:

  1. Alex had the hydroceles and they gave him a spinal block. He had trouble walking for a couple days (he walked like an old man hunched over). Other than that the recovery was smooth. Heartily agree that insurance sucks because they refuse to cover my ABA therapy.