Tuesday, 17 August 2010

A Bit Off

Yesterday I found a letter from Blue Cross in the mail. I almost didn't open it, because I figured it was yet another privacy statement, but, decided that in my new zeal for a clean desk I should get it shredded right away. I was shocked to find a claim denial inside. A claim denial for my ob appointment just prior to giving birth and for my care at the hospital. Almost three thousand dollars worth of care. Care that I was insured for. Care ordered by my primary doctor. Care I paid premiums for.

So, I was irritated. To be clear, this was not a bill, simply an explanation that Blue Cross was refusing to pay the hospital for my care. Blue Cross was saying that I didn't owe either- that neither of us should be paying.

So, I called my medical group claims processor, and she explained that they have indeed denied the claim because the hospital did not submit the necessary claims paperwork according to whatever laws and rules govern medical insurance, and therefore Blue Cross owes them nothing and has no obligation whatsoever to pay. She said I had no obligation to pay either, and that the hospital had to write the care off as their mistake.

Fine. I don't care who pays or doesn't pay just as long as it isn't our responsibility. But, there was a catch. This is how the conversation proceeded:

Me: Ok, so I shouldn't worry about any of this?

Rep: Well, have they sent you a bill?

Me: No, but we have moved since then.

Rep: I would call. Sometimes they just send these things to collections and that can be hard to sort out. If they say they are planning on charging you just have them conference call me and I will tell them they can't.

Me: Fine. What's the number?

(In my head: Are you kidding me? Collections? And you are just going to tell them they can't? AWESOME.)

I called right away and have not heard back from the hospital billing department. I am a bit frustrated about this, because, although I doubt they will bill us, or send us to collections, or whatever, it seems a bit absurd that I should be dealing with this a full TWO years after it happened. Two years. After all this time I shouldn't be getting mail about the dispute between my insurance company and the hospital.

Furthermore, getting the mail has put me in a bit of a funk. It was just such a negative reminder of that time, and it has really been hanging over me. I don't know if it is just the unresolved issue (and the possibility, no matter how remote, of having to fight a collections agency), or that I just don't feel like remembering that pain. We had to do more calling than I would like about some paperwork errors and claims issues within a few months of Leah's birth, so doing those same tasks really dredges up memories of how paralyzing and painful that time was. After I left the message with the hospital yesterday I felt completely drained. Today Tommy and I went out a few times, and each time when I got back the first thing I did was check the message machine (which I usually don't care about), because my stomach is in knots over this. Not because I don't think it will work out, but because I don't want to even think about it.

6 comments:

ktruelove said...

love you! i'm sorry this happened:(

Gretchen said...

How frustrating! So sorry that you have to deal with this!

mary said...

Amy I am so sorry that this happened. Love you mom

Heather said...

Oh yuck! I had some horrible insurance issues after births too and I do NOT like to think about it either. I was cleaning out our file drawer over the summer and it brought back bad memories. I'm so sorry this has even come up!

thecurryseven said...

Oh that stinks!! The whole thing. I'm so sorry you even have to think about this.

sara said...

ehhh. what a way to start off a week! I am sorry Amy!! That is sucky...Have you heard back yet?? I am praying that they get back to you soon and you don't have to do a thing. Praying for peace to fall over you! much love.