Friday, May 13, 2011

Victory is Ours!

Remember at the beginning of March when I posted about the insurance company? They've been giving us the run around for 5 months now and refusing to reimburse for Secora's birth even though the policy states (and we confirmed prior to delivery) that they cover home births with licensed midwives. Josh called every week and always got a different story out of them. Finally he threatened legal action and got a supervisor to work with. And apparently, nothing at all had been done on the claim. She sent it down to Texas (because that's where the birth happened), and they refused to pay because my midwife is not in their system as a provider. So she entered it in Maryland (where our insurance is) instead. Now, I'm quite certain my Texas midwife isn't in Maryland's system either, but I guess it doesn't matter up there? This all makes so much sense.

We got paperwork yesterday stating the allowable expense for maternity care (it's a global charge...covers all prenatal care and delivery) was only $220 and since our deductible is $250, nothing would be paid. I. WAS. MAD. Two Hundred and Twenty dollars is supposed to cover all maternity care?? That's a big stinkin' heap of doo. They'll pay that on one visit alone to an OB. I was ready to bury some poor person under paperwork and phone calls until they wrote a check just to get rid of me. Forget the money, now it's the principle of the matter.

Then the mail came today. With another statement. You wanna know the sweetest part of that statement? This line right here:Uh huh. The one that says, "oops, our bad, made a mistake!" Apparently, someone left off a zero when they were entering stuff in the system (shouldn't the "allowable expense" part of these things be automated?) and they actually allow $2200 for maternity care, which is much closer to what it actually costs, so I could stomach that. I still don't agree with the denial of the other charges, but the payout on those isn't worth the further headache, frankly.

Included with the statement was a big fat check. Finally.
So I suppose the moral of the story is that if you want a health insurance company to actually honor their own stinkin' policy, you only have to make approximately 20-25 phone calls. Reasonable, right?

Blog Issues: As many of you know, Blogger had trouble with some scheduled maintenance they were running and the whole system was in "read only" mode for a while. They went back to May 11 settings, and the posts that were put up after a certain time on May 12 (mine included) aren't visible because of that. Blogger says the posts will be restored soon.

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