It's been months since I last wrote about my ongoing battle with BlueCross BlueShield of Texas, and, unfortunately, the problems are no closer to being resolved.
In mid-April, BCBS sent a letter to the hospital, copying me, stating that my claim for Elizabeth's birth was denied because there was no evidence that the situation met any of their definitions of complicating factors. Once I stopped sobbing, I called the insurance company. The woman I spoke with told me that no one should have ever told me the delivery would be covered because they were just in customer service, not medical review. So I asked how to appeal the decision and whether I had a deadline.
My next call was to my doctor's office, and I sobbed on the phone to the nurse about how I was having continued panic attacks every time I got the mail and saw another hospital bill or insurance envelope and every time I saw the hospital billing office number come up on caller ID. She passed a message along to the doctor and then called back to say that the doctor would be sending an appeal letter on my behalf.
That was in April, and I hadn't heard anything back since. I called once last month to find out what was going on and was told the claim was pending. I called again on Wednesday, and this time the woman I spoke with (and yes I have notes on whom I spoke with and when for every call) told me the claim was denied as of mid-April. That denial was the one that caused me to call my doctor's office in tears.
I told the woman that my doctor was supposed to have sent a letter about the appeal, and she said they hadn't received it. The BCBS woman assured me that I hadn't run out of time to appeal, and I told her I wanted it clearly marked in my records that I am officially appealing the denial.
Then I called my doctor's office. The nurse promised that the letter had been sent and even read it to me. She said that insurance companies "lose" letters all the time and that she would re-send it. So now I have to call back next week to make sure BCBS has received it and that whoever is supposed to be reviewing it actually is.
I mentioned this whole saga to one of my editing clients, and he told me that my next step should be to pay an attorney to write a letter to BCBS, copying my legislators, informing them that I am not willing to give up on the claim. I never wanted to HAVE to hire an attorney, but I will if it comes down to it.
My stress level about all of this had dropped drastically in the past few months. I haven't had a panic attack while getting the mail in ages. But it's all come back now; I've been upset ever since the calls on Wednesday.
I'm also amazed that the hospital hasn't been calling or sending letters looking for their seven thousand dollars. They called at least once a week and sent regular collection letters in the early weeks of this fight, but I haven't heard a peep lately. I'm a bit scared to call them and check on the account, though. I figure that if they haven't noticed me, I'm not going to call attention to the account.
On Wednesday I tweeted (I'm still not sure I like Twitter) that I wished I had Dooce's influence. She posted several tweets about a broken washer and her failed attempts to get it fixed or replaced, and within hours her washer was fixed AND she had a company offering to send her a new one for a give-away. If I had more than a million readers and followers, maybe someone at BCBS would pull his head out of his a** and fix this.
I hate, hate, hate that I am having to go through this again. I really feel that I lost out on some of the joy of Elizabeth's first few months because I was so worried about insurance and medical bills - and we actually have insurance. I can't imagine how hard it must be for those who don't. And every time I hear someone at a tea party or at an anti-reform rally saying that they don't want the government running health insurance, I want to kick them. If we lived in pretty much any other industrialized nation in the world, I wouldn't be going through this. There would never have been a question about whether the insurance company would pay for the delivery - it would have just been taken care of.
I need to stop writing and thinking about this now. I'm on the verge of panicking all over again.