Wednesday, October 17, 2007

This is beyond ridiculous. We've had so many problems with insurance companies, I don't know what to do anymore. It's one thing after another, after another, after another. Yesterday afternoon after we came home from Logan's appointment I got a call from the allergist's billing office. They tried to bill the insurance company only to find out that the claim was denied because the policy had been canceled...AGAIN.

We signed up with the company in May. Logan has his 18th month check-up in mid August. We found out that the insurance company canceled our existing policy after 30 days & switched us to a different carrier because we didn't check a box on the application (that we were never informed of when sitting down with the representative). Logan's visit was denied & we were held responsible for the bill. The billing office of his pediatrician said that they had a form that I could sign that would get us back on the original plan. I went in, signed the form & they faxed it in to the insurance company.

We waited until it was confirmed that we had coverage before proceeding with the referral to the allergist's office. The pediatrician's office got the go-ahead & sent in the referral to the allergist. I received an insurance card in the mail with the new effective date as 10/1/2007. I also received a copy of the referral in the mail for 3 visits effective between 10/4/2007 - 1/4/2008. Everything I had in my hands said that we were able to go to this appointment.

This is why it came as a complete shock when I called the insurance company to find out why the claim was denied & I was told that the policy had been CANCELED 10/1/2007. I don't get it. I don't know what else I could have done to make sure we were doing everything we were supposed to do. If the policy was canceled, then why did I get a NEW card with a NEW effective date? If the policy was CANCELED then WHY did I receive a referral for three visits with the START date beginning AFTER THE POLICY WAS CANCELED? Why was the policy even canceled AGAIN anyway? If this is really canceled, it means we had coverage for one day. They reactivated then canceled the policy in less than 12 hours.

Other than crying on the phone & waiting for them to figure this out, I don't know what else to do. Every single time we go in for an appointment, claims are denied. We have paid more out of pocket & have been held responsible for thousands of dollars that the insurance company was supposed to pay. It's as if we don't have health insurance. This card in my wallet means absolutely nothing, the money we've paid the insurance company for coverage is only paying them to deny all coverage...the health care system in America is beyond corrupt & it is drastically effecting our family & our financial wellbeing.


Shannon said...

I found your blog through another one, but forget who... I have had issues with my health insurance, but nothing like this... I am so sorry... but maybe it is time to get a lawyer to get involved to fix this mess! Btw, my real blog is here-

Dawn B said...

oh my god!!! I don't get it either... and all because someone isn't doing there job right..someone who's getting PAID to do a good job. This sucks. I hope this clears up real soon.

Jaime said...

This is just terrible and so very wrong, yet I understand as the same thing has also happened to me.

We have BC/BS and I cannot tell you the number of times I've been on the phone with these people arguing over claims. When each penny counts and you're on a budget this kind of thing understandably is upsetting.

I hope it is all resolved and you don't have the stress. I'm sorry this is happening.

Jenny said...

Sadly our country's health care system is going down the toilet fast. I am reading three books about health care systems, and let me tell you, the reality of what goes on is inhumane. I can only hope we revise our system so people who are hard working like your family don't suffer the consequences of the poorly run status quo.

Mof2 said...

I really hope that you get it all worked out..No I hope the insurance company gets it all worked out...This is so not your fault. They are always out to get the little guys! Good Luck!

nancy said...

Wow, what a pain. Sorry it's happening to you again! :(