Thursday, October 21, 2004


I hate insurance companies. Not just because I work for a hospital and I see all the money they are pocketing between the non-profit hospital and the patients. No. I also hate them for all the hoops they make patients jump through. Tonight I am living proof.

Around Sept 7th, I set up my appointment for my amnio tomorrow. The perinatologist's office stated I needed authorization in writing or I wouldn't be able to have it. I called my insurance who told me it was a covered benefit and that I wouldn't need paper authorization. I explained that I did and they said that they needed a written request from my doctor at least 30 days in advance. No problem. I called my OB/GYN and they made the request. United says they received it on 9/13, so they should be able to provide it for me on 10/13, well in advance of the 10/22 appointment. Right?

So I decided to call today and to see how everything was going. My OB/GYN's office said they never received anything. The perinatologists office says they never recieved anything. I never received anything. I ask my OB/GYN to follow-up and urgently because this appointment is tomorrow. After many promises that they would, they didn't and they closed without calling me back. Gee, thanks.

So I call Unitedbastards. They tell me that my request is in medical review and they have no idea how much longer that will take. Is it a covered benefit? Yes. Then why the medical review? Because I asked for paper authorization. Why is it taking so much longer than the 30 days they promised? They don't know. What can you fax me or my doctor tonight so that I can still have my appointment tomorrow? Nothing. Nothing at all.


So, next I filed a complaint with the California Department of Insurance. Then I called the California Department of Managed Health Care and filed a complaint with them. They said they would file it as urgent, but still, it's late. There's nothing they can do for me tonight. They promised to have their agents look into it and call me tomorrow.

That leaves me exactly nowhere. Yes, I took out some of my anger by filing these complaints, but I'm still left with an appointment tomorrow and no all important piece of paper for a benefit that is COVERED. It is covered no matter what. What are they going to do in a medical review, deny my claim? No, but by not providing me with this paper in time, that's exactly what they are doing and they know it. Don't be naive, these insurance companies care only about one thing and that's profits. Their tactic is to delay, delay, delay and then deny, deny, deny. Set up many obstacles to avoid paying for, or in this case even receiving services.

I did everything I was supposed to do with plenty of extra time just for cushion. They are playing games big time. They are so unapologetic and so smug. "We're not denying you services, the perinatologist is by not giving it to you without this paper. It is covered." "Yes, you are denying me services since you knew that I needed this paper to receive the service. Bastards." Actually, I didn't call them that on the phone, but I think it could be implied by my tone. Or at least I hope it was.

So I don't know what's going to happen tomorrow, but more than likely nothing. All this stress, all this worry, all this planning and preparation for nothing. Like as if getting an amnio is the easiest thing in the world. As if I should just say, "Oh I understand, you lied about how long it would take you and now I'm screwed. That's okay, no need to apologize. At least I'll know that the amnio I'm unable to get is covered, right?"

Oh, and by the way, the reason I set the appointment so far in advance is because it is impossible to get an appointment for an amnio there without at least 30 days notice. Which leaves me with the option of.... nothing. Exactly nothing.



Anonymous Anonymous said...

I've always said there is a special place in hell for insurance companies, an oh so special place.

Sorry for all the aggravation. At least with my insurance company they never even made the pretense about anything related to me and IF being covered so I never had any surprises.

Sigh. Sorry for the stress. Hope you get it resolved soon.


9:11 AM  
Anonymous Anonymous said...

I spent a year trying to get a SIMPLE answer from UHC, I even had an 'advocate' from my employer trying to help me and she threw up her hands. Recently, while pumped up on all the hormones on the east coast, I spent an entire day heaving four letter words on the phone until I got a level 5 manager. Level 5 baby. I have his phone number yes his real phone number if you want it email me I also managed to get a hold of the level 4 lady that was 'helping' me that totally lied to me several times, I called to every word in the book and I think I made her cry. But you know what tough shit.

I too paid out of pocket for a service that should have been covered.

They are a fucking bunch of lying jerks. I work for a big big name financial institution, we have four health plan provider and 8 or 9 plans, and we dumped them this year, you have to suck a lot for us to drop you.

I could not hate them more.

5:49 PM  
Blogger Menita said...

Bastards. They are evil itself, they are just awful. You are PREGNANT for heaven's sake - would a little compassion kill them? Come to think of it, maybe it would.
I hope everything went well with the amnio, P.

8:06 PM  
Anonymous Anonymous said...

If it makes you feel any blood is boiling now and I have just created a blood pressure problem. So I will have to go to the doctor and run up a bill that the insurance company will have to pay.

Ok Ok Ok it is not the greatest of all plans to get back at the insurance company but it is the best I can do on such short notice.

I am sorry for your annoying.....effing jerks

-alex from the kitchen of the boiling infertile gourmet

8:02 PM  
Blogger job opportunitya said...

Unusual blog. I liked the site its from so much I
have to visit it again! I surf the web for blogs like
yours in my spare time.
Please consider looking at my plastic surgery illinois blog.

11:29 PM  
Blogger job opportunitya said...

Awesome blog. I'm loving the site and I have to
return there soon! Going online, when I have the time,
I look for blogs close to your work!
Go and click my celebrity plastic surgery blog.

1:45 PM  
Blogger job opportunitya said...

Creative blog.  I thought it was the best site out
and we had to go back to it! Every chance I get on the
net I search for blogs just like your site.
Please take a journey to my free plastic surgery blog.

2:54 PM  

Post a Comment

<< Home