Insurance. Glad I have you, but you are a pain.

by , under my health, personal, Pirate

I am lucky. A lucky, lucky girl. We have insurance through TheBoy’s work, and it’s a pretty good insurance.

That said, health insurance still manages to make my life difficult.

TheBoy started a new job little over a year ago, and I wouldn’t say that I had any particular health issues around the time of the transition from one insurance to the other. Just the usual doctor’s visits. But I did have to notify my doctors of my new insurance, and there were a couple things that were misbilled. But I spoke with people at my old insurance and my new insurance, and that was that.

At least I thought it was.

In the last year, I’ve had to call my insurance company 5 times because they’ve tried to say that the old insurance was my current primary insurance. Five times. And then it happened last week again. So I called, spoke with a very nice woman about my claims that were pending.

And now I got a bill for my CT scan that says my insurance claim was denied. I’m 99% sure that it was because of last week’s issue. Which means that I get to call whoever handles the billing so that I can try to get them to resubmit the claim.

And likely have more of these issues to deal with in the next month- because obviously, I have a disease that isn’t going anywhere. They know I’m going to be expensive, so if they can’t pay for something, they’re going to find a way to try to get out of it.

I know, I’m extraordinarily lucky that I have insurance. It’s just stressful to have to fight with people to get them to cover what they’re supposed to. And unfortunately with Crohn’s, stress leads to flare-ups.

  • My sister worked in a doctor’s office for a while, re-billing claims. She said it seems to be standard practice on the part of insurance companies to routinely deny a certain % of claims even when there isn’t any confusion, and I’d have a hard time believing she’s wrong.

  • It certainly makes sense to me. They are run as businesses, not services. So they need to try to make a profit. I’m sure that there’s a percentage of people who just read that the claim was denied and they just pay the bill without trying to fight it.

    I can’t help but be struck by the irony. The denied claims cause me stress, stress leads to more flare ups, flare ups lead to more doctor’s visits… which lead to more claims. I’d think it’s in their best interest to keep me happy. 😉