I have been dealing with hospital bills and insurance claims for Elizabeth's birth since mid-December, and there doesn't seem to be any end in sight.
Insurance coughed up for Elizabeth's 7 days in NICU. The total bill was along the lines of $22,000, and insurance paid for 80% leaving us with the rest. I've arranged a reasonable payment plan for the amount and should have Elizabeth paid off before she gets to kindergarten.
The problems lie with my c-section. Our insurance plan doesn't cover pregnancy or delivery, so technically, BCBS wasn't supposed to pay for the delivery. However, Elizabeth's early arrival constituted a "complicating factor," which means BCBS is supposed to pay. They paid for the anesthesiologist without a problem and then denied the c-section because the hospital coded it as a scheduled delivery instead of an emergency.
On the advice of the insurance company, I called the hospital and askend them to resubmit the bill with the proper coding, which they did. Insurance denied it again, so I called them back and was told that the hospital needed to submit my medical records to prove that it was an emergency. It would have been nice if they had told me that the first time.
I called the hospital and gave them all the information they needed to submit the medical records - claim number, fax number, contact name, etc. Next thing I know, I'm getting recorded calls from the hospital demanding payment. I call the hospital and am told that the request for medical records needs to come from the insurance company directly. Again, it would have been nice to have been told that during my last call. I tell them they are now responsible for getting the request from the insurance company. The "supervisor" I spoke with promised me he would and that he would call with an update. That was two weeks ago, and I still haven't heard from him.
In the meantime, with the help of two friends who work at the hospital, I got the name and contact number of someone in the business office who helps with such things. I left her four messages over two weeks before I get a call back. She couldn't find any record that I have insurance. We have switched insurance in the past few months, so I no longer have my BCBS insurance cards. I gave her all my BCBS policy information, but she wasn't sure that would be enough to submit the claim. I pointed out that BCBS has paid for Elizabeth's stay and the anesthesiologist, which means they got my insurance information from hospital at some point. She said she'd research it and call back. You guessed it - I haven't heard back. I left her a message on Friday.
Today I decided to become the unhappy client from hell on this. I'm tired of being polite and patient. I'm tired of not knowing how much money we're going to end up owing. And I'm stunned that the insurance company is willing to pay but the hospital can't get its act together to collect the money.
I called to talk to Michael G, the "supervisor" who promised to call me back. Big surprise, he wasn't available. So I asked to talk to his boss. The man who answered my call came back on the line to tell me that all the managers were in meetings. So I said I wanted a call back today. But this traps me in the house. Even though I gave them my cell phone number, I can't exactly spread out all of my paperwork in the produce aisle if that's where I happen to be when someone calls. I'll give them until 1:00 before calling back and raising hell. And I'll be calling the woman at the business office again.
I'm done with being patient and nice.