Friday, August 29, 2008

Glitch

This morning I found myself questioning whether or not one can actually feel an aneurysm--- assuming such a thing could occur as a result of mounting blood pressure. (Unlikely, but it seemed like a distinct possibility.) After the barrage of expenses this week for assorted items not included in pre-paid school supplies and band fees, we had a really nasty surprise. The purse strings are beyond feeling a pinch. The latest trauma kicked in while I was checking our medical claims.
Two weeks ago, I discovered that June and July claims for a $5K treatment that rolls around every four weeks had been denied because someone processed them improperly as pharmacy claims rather than home health claims. While rooting around in the claims information, I was bewildered by the website showing $2100 to go in our out-of-pocket and $1400 paid out thus far this year despite six $450 payments coming out of our pocket plus a host of smaller claims for labs and outpatient procedures. That precipitated another phone call to the world's rudest rep. (Thanks, Crystal, you have made an already stressful situation worse. Good customer service does not ever involve making the client feel stupid.) The next rep was actually helpful, and he figured out quickly that our $300 deductible was met, but not applied, and that claims where we were paying were not being accumulated in our out-of-pocket total because of a computer glitch. Hallelujah! Praise the Lord for someone with brain cells and a kind demeanor answering this morning's call!
As frustrated as I am with the situation, I am also relieved to know that in fifteen business days, we may finally have a resolution. Fortunately, the company providing the mega-bucks treatment has agreed to accept what is likely our actual amount due while waiting on our goofy insurance company to untangle the mess with our numbers. Perhaps other customers will benefit from the insurance company correcting the computer issue as well. I can hope that there will be benefit to others out of my own situation at least.

1 comment:

Lori said...

OUCH! We just had one of those "glitches" with insurance, too. A $6200 bill. Ins. Co. told medical office that we had not been covered since Sept of 2004. Funny, we didn't have said Ins.Co. until July of 06. AND med office HAD received payment from Ins Co (under which we had "not been covered" HA!) in April. They were nice about it though. I despise rude "customer service" people.