Tuesday, March 13, 2012

Navigating our byzantine health care system

In the continuing saga of my COBRA medical coverage, I decided to wait to see if my account would be updated on Monday. This company does a lot of batch processing over the weekend even though we're in the 21st Century and most database get updated instantaneously or at least nightly. But by end-of-day there was no change, so today I called them.

As usual the person I talked to was very nice. They also had the same "no worries" attitude that they all give out. Oh, don't worry, we did process your check. We just cancelled your account because we do that automatically on the 4th or 5th of each month, if we don't get your check by then. No biggie, right? Okay, no one said directly "no biggie" but they might as well have. They act like everything is "no big deal." But it's my health insurance so everything is a big deal!

So, I say, since every month you erroneously cancel the insurance of at least a handful of people who live in a part of the country where the mail takes longer to get to you, that must mean at some later date, you automatically put them back on.

Oh no, you have to call for that to happen, she tells me. But, don't worry, you called, so I'll put in the request for you to be re-instated.

But all the paperwork you sent me said that my insurance was cancelled and that it would not be reinstated once they got my check, end of story. There was nothing in there about, oh, we'll reinstate it if you call. What if I had never called? Or I waited a week to call, thinking I wait for them to do it automatically, and they had already notified my insurance company that my insurance was cancelled?

It's just so weird. And what's weirder yet is that everyone you talk to acts like this is all perfectly sensible and it's "just the way it works."

Of course, as an engineer who can never stop designing and/or improving systems even if they aren't ones I'm being paid to design and/or improve, it makes me itchy just thinking about how completely un-customer-friendly and inefficient this system is.

But, supposedly, assuming my check really was post-marked March 1st, some time in the next 2-5 days, my insurance will be turned back on and they'll send me a bunch more letters with various Confirmation and Certifications of that.

The only thing to worry about now is the Post Office screwing up and not post-marking my envelop the day I mailed it. I actually drove to the Post Office on the way to work and used the mailbox in front of the building that gets emptied several times a day. So there really shouldn't be any reason the postmark isn't correct. It's just one more thing to worry about because apparently the post-mark doesn't actually get put into the system so the gal I talked to didn't actually know what it was.

One good thing: it looks like at least part, if not all, of Mini-Mac's surgery was processed by my insurance company already and they are "in process" of taking care of MacBoy's enormous hospital bill.

I'm still a bit worried about that one -- and have been since the day he was admitted -- because mental health benefits on most policies, including mine, are so screwy and limited. It worries me that they've processed bills he incurred after he got out, but not those two big bills. But at least they aren't balking at his therapy bills or his medications. I have friends who have to fight constantly to get their insurance to actually pay their therapists because everything they submit is just automatically denied.

I figure, it will be a lot easier to fight with Hewett if the insurance company has already paid the bills. They can threaten to make me pay them back while I'm fighting them, but I won't have to fight them and simultaneously fight the doctors and the surgery center and the hospital who are clamoring to be paid. It puts me in more of a position of power than if those bills weren't paid.

But hopefully I won't need power and it will all just work out.
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