Do Whatever You Can To Avoid Being (a) Patient
Take Good Care, and Ask Good Questions
Greetings, Humans!
Please stay patient with the tone of this post. I am writing it out of frustration and a desire for things to get better. It is not aimed at any one person or entity, just a space to vent while I continue to work towards a brighter future. It doesn’t have to be like this, and I’m worried it’ll get worse. In the meantime, here’s the briefest synopsis of an ongoing yet minor complication regarding billing with private health insurance and the denial of a claim that should have been approved. Cheers!
I am in the process of appealing a claim with my employer-provided health insurance plan for an ambulance ride between one in-network hospital to another higher level of care (also in-network) for one of my kids.
It’s been slow, frustrating, and time-consuming. And really, in the grand scheme of things, a gigantic waste of my precious time.
All things considered, it is literally the most first-world problem there is. Private health insurance profiting off of our scattered attention and busy lives, and banking on our lack of follow-through… thanks to our 40+ hour work weeks and multitasking personal lives.
My employer’s health insurance is through UMR - a United Health Care Company.
The dispute is regarding an ambulance ride and their denial of a claim.
My bill from Superior Ambulance Company was for almost seven thousand dollars. Yes, that’s right. In addition to my biweekly premium (the amount I pay out of pocket just to have health insurance), and the $50 spousal surcharge (that I also pay out of pocket biweekly to insure my spouse — because his employer offers health insurance, so why isn’t he on his own plan??)…
And my unmet deductible…
I was asked to pay almost $7000 for a ride from one hospital to another, as recommended by the emergency room doctor. No meds, no actual care, just a ride in a fancy truck and a few co-pilots.
That ain’t right.
Now, I speak the language of healthcare.
I know this is a problem, and there’s no way I should be expected to pay that much out of pocket…
But what I’m finding out is… this is not a unique experience.
It is the same experience as a colleague who works in the ED where we received care (same situation for her own kid being transferred in-network) (our mutual employer).
And the same for… cough… Bob’s Wife!!! Who also works for our company… whose bill was even higher.
Okay — earmuffs kids — what in the actual fork is going ON HERE??!!
I’ve spent significant time on the phone with UMR, Superior, and Patient Relations at my company to get to the bottom of this. Time I’d much rather spend on… well… anything.
And this weekend — like a Christmas Miracle — I received a letter from UMR that my “denial of the above referenced claim has been reversed. Your claim will be reprocessed…”.
YES!!!
Thanks, Santa.
My next wish is that you please, for the love of all that is holy and good in the world, help us win the battle with the Pirates on the Tugboat Insurance and rewrite me a story where the good guys win.
I’m trying to remain patient. I’m trying to do things right, follow the rules, seek care where I’m supposed to. And… I keep getting proven right — that healthcare and private insurance are a crumbling, fumbling industry and it’s not safe to be here anymore. Santa — Help. HELP! Santa, please??! Splod? God? AI? Chat GPT?
Somebody — figure this out and make it better. Soon.
Please.
Amen? Or whatever. Thanks.
Take good care!
Love,
Jessie
Where does one even begin to start this conversation? Let alone do something about it? A year or so ago I read Marty Makary's "The Price We Pay". Every chapter offered in great detail how nearly every aspect of the economics of healthcare have been gamed. Transportation was only one example. So, even if solving your problem has a good outcome it does not solve "our problem" of waste etc. And, of course, the emotional toll on all who are impacted by the "dumb system" we created and tolerate. What support might be helpful?