Paraphrasing



Six months ago I had my annual checkup with the doctor.

His lab-tech that usually draws my blood went home sick that day so I had to go over to the hospital in that town to get my blood drawn, which is a regular part of the annual exam.

And is covered 100% by insurance since it's part of my wellness checkup.

So when I went over there and did all the paperwork I made sure to tell the office lady, the lab tech, and later the insurance lady that it needed to be billed as wellness so they would get all of their money from the insurance company.

Fast-forward to February when I get a bill from the hospital for the 20% that the insurance didn't pay because they didn't bill it as wellness.

So I call and I talk to a woman.  We'll call her The Most Unhelpful Woman in the World.  Or TMUWW for short.

Just a FYI:  I imagine her in my head to look something of a cross between Kathy Kinney's Mimi character from Drew Carey and Kathy Bates' character in Misery.

Here's a paraphrase of the conversation.

Me:  Hi, I was in there in November for some bloodwork for my wellness checkup with Dr. GoodDoctor's Office.  It seems the paperwork wasn't submitted as wellness and so my insurance company didn't cover the full amount of the charges, as they should have.  Can I get you to resubmit the papers so that they'll pay the rest of the bill?

TMUWW:  No.  You need to talk to your doctor's office.

Me:  Okay.  What do I need to speak with them about?

TMUWW:  They'll have to change the diagnosis in the computer.

Me:  The diagnosis?  I was just there for routine bloodwork, it wasn't for an illness.  You can't just resubmit it as wellness?

TMUWW:  No.  You need to talk to your doctor's office.

Instead of calling my doctor's office, I called the Medical Records office of the hospital and was told to contact my insurance office and make sure it would be covered.

I called my insurance office, they said no problem, get it submitted and we'll get it paid.

So I called back with that information and Medical Records said that it wouldn't be a problem and they'd get it resubmitted.

Fast-forward to March.

The twenty-ninth to be specific.

Bill #2 arrives showing I still owe the 20% that insurance would have covered.

So I call back and who do I get but TMUWW.

Me:  Hi, I was up there in November for some bloodwork for my wellness checkup with Dr. GoodDoctor's Office.  I spoke with a lady up there last month about it being resubmitted to my insurance company and I was just following up to make sure that had happened since I got another bill today.

TMUWW:  No.  You need to talk to your doctor's office.

Me:  I spoke with a very helpful lady last month who said that it was being resubmitted, I just wanted to make sure that happened so that the hospital can get the rest of their money.

TMUWW:  I do the insurance and I'm not resubmitting it.  You'll have to talk to your doctor's office.  Unless they change the diagnosis I'm not resubmitting it.

So I gave in and called the Dr. Good Doctor's Office and his always-helpful staff was happy to help intercede so they called the hospital and talked to one helpful woman, who talked to another helpful woman who said "No problem.  I'll resubmit it right now and that should take care of it, but give us a call next month if you get a bill and just make sure everything got resubmitted and squared away."

And here I am today with bill #3 in hand.

So I call the number on the bill and who answers the phone but TMUWW.

Betcha can't guess what she said?

Same song, third verse.

A little bit faster and a little bit worse.

I'm trying to help them get their money.  You'd think she'd be willing to work with me but instead she wants me to just cough up money that I shouldn't have to pay so she doesn't have to get all professional and do the job she's being paid to do.

As if insurance doesn't have tendency to be frustrating enough as it is, it gets even more complicated by dealing with people like this!
Ashley Wife & Mom

Ashley is a thirty-something wife and mother of two boys. She enjoys spending time with her family, as well as reading and decorating their home. Her blogging adventures began in 2006 as a single mother and have carried on through marriage and a new life with a husband, a ten-year-old, and an infant.