I don’t know why people think of DOGS when the subject of heroic pets comes up. Why, just this morning, one of our cats realized he needed to throw up and, with Indiana-Jones-like reflexes, immediately emitted an unearthly yowl to alert the sleeping household to the emergency. As I was still trying to figure out what time it was and how to walk without falling over, he realized something even more serious: he was on a HARD FLOOR! With no thought for his own safety, he ran as fast as his plush paws could carry him down the stairs to the only carpeted area of the house. Just in the nick of time he reached the bottom step. It was a very close call, but he managed it. A true hero for our times.
I have not yet thanked you all for your responses to the Frustration Crying post. I kept seeing comments and thinking, “Yes. YES!” Then I’d start to respond, and feel like I was just repeating myself—or worse, repeating the comment itself. And then it seemed as if it would seem as if I wasn’t responding to OTHER comments because they WEREN’T good, rather than because I didn’t have any response other than gratitude and relief and comforted feelings. Anyway, the whole incident threw me for a bit of a loop, and in a loop like that everything seems impossible to figure out, so let’s just leave it at THANK YOU FOR ALL THOSE GREAT COMMENTS.
Today I am continuing to have this “WHY IS THE LEAST-KNOWLEDGEABLE PERSON IN CHARGE??” feeling about doctors and insurance and so forth, because over the weekend we received two letters. One was from our insurance company, saying “Referral? What referral? We never received any referral, so here is a heads-up that you will have to pay the entire $400 specialist fee yourself.” So I will need to call about that. It’s possible that there WAS a referral. It’s also possible that the pediatrician’s office forgot to send it over. If the pediatrician knows there needs to be a referral, which they do know, and if the specialist knows they need to receive the referral, which they do know, and if the insurance company knows everyone knows this, then WHY OH WHY do I have to be the one to call this morning to ask the pediatrician to send the referral to the specialist, and to ask the specialist to send it to the insurance? Why can’t THE PEOPLE WHO ARE PAID TO DO THIS be the ones to do this??
The second letter was from the specialist, saying that because we have no insurance information on file, they are giving us their uninsured-patient discount. Well. That is very nice of them, and it’s a surprisingly nice discount: it takes off about half the charge. But since I stood at a registration desk for OVER TWENTY MINUTES giving them our insurance information and trying to answer questions such as “When did this insurance coverage start?” (I don’t know, like five years ago I guess, THIS IS NOT INFORMATION I USE BRAIN STORAGE SPACE FOR), and telling them Paul’s Social Security number and birth date, and letting them scan the card, I don’t know WHY I now have to call them and give them all the information again.
Also, if they have no insurance information on file, why is our insurance company alerting us that they’ve received a claim and the visit will not be covered?
It does help to realize that most of this is done automatically by computer. That is, it isn’t as if a person at the specialist’s office deliberately ignored our insurance information; there was just some reason the computer couldn’t process it, so the computer printed out a letter. But it also DOESN’T help, because wouldn’t it be nice if a person DID check before sending out one of these automated letters? Just a quick double-check to see if perhaps alllllllll the information was already in the computer and some glitch just prevented it from processing? Since I think we all know how unpleasant it is to receive such a letter? Well. It does no good to think these counter-reality thoughts.
Follow-up: It is only fair, especially after making cynical remarks about reality, to say that when I called the pediatrician about the missing referral (shortly after writing this post) they said, “Oh, yes: the specialist called us Friday and we faxed it right over.” So! The very people I would LOVE to have handle the situation, DID IN FACT HANDLE IT. The specialist’s office saw the issue, understood the issue, and took action! The pediatrician’s office responded by fixing the issue! EVERYONE GETS NEW CARS.
Our cat performed a similar act of heroism last night, too! So grateful that I got to clean his barf out of the carpet this morning when there is hardwood floor a mere three feet away. #blessed
Cats are the best, aren’t they? Ours actually force themselves to vomit in the morning to wake us, if their food bowl is getting perilously close to empty. We left for the weekend and amazing, no vomit!
Glad to hear you got some satisfaction in the referral situation, although still very frustrating to have all this happening at once.
It is such a weird, ingrained drive, this puking on the carpet. We have no carpet in our house and only a few rugs. Most are the Flor tiles that are super easy to clean and/or just replace. But one is a jute rug that is IMPOSSIBLE to clean. Impossible. Guess where the cats always barf.
It’s nice to know your cat is willing to go the extra mile for you :)
My husband ended up at the hospital in an emergency situation this summer (he’s fine) and did not have his wallet with him. When I got there, I supplied the information, but for some reason they decided we didn’t have insurance even though the information was right there in the account. So I kept getting bills that had the correct insurance information listed, and then a notation that they had not billed our insurance. So then I would have to pick up the phone (and much like you I HATE making phone calls) and point out that I would not pay them until they had billed our insurance. Six bills/phone calls later it seems to be finally straightened out.
Cats hurling on carpets. Yep. Always. It is their special superpower.
I am currently holding my breath on our latest medical need. Will all the nurses/anesthetists/etc. be on our insurance? Did everyone receive the appropriate paperwork? Will there be something that has to be paid from deductible or was it just the copay this time? Sure adds a layer of angst to what was already a difficult time. I’d prefer to just be worrying about what the results of the procedure are going to be, and if I will have to put my little boy through this again or through something else… oh wait. I’d rather not be dealing with any of this at all, but it’s life.
When I was a kid, we had a cat that barfed only in the kitty litter. What a cat!
My current cat heroically hides her vomit in places where I would not think to look, like under the baby’s crib and behind the shoe rack in the closet.
A story of the computer vs. a person: at the hotel where I used to work, we would review room balances each day and then secure additional credit card authorization to cover any amounts that weren’t currently authorized. Basically, you would be pre-authorized for the cost of your room plus change to cover some incidentals, and if you charged drinks to your room for $50, then we would get additional authorization for, say, $75. I hope this makes sense so far.
But, basically, the computer didn’t distinguish between someone whose room charges had already been paid through a travel site and someone whose room charges were going to be paid on their credit card, so it was necessary for a human to double check OR ELSE THIS WOULD HAPPEN: a nice couple from Scotland were staying with us for 2 weeks and had prepaid through a travel site. Our night auditor didn’t bother to check and so went ahead and put an $1800 hold on their credit card, rendering that card useless to them and also setting off a bunch of bank red flags for massive overseas spending. Meaning that they ended up having the card declined as they were out for the day, making them freak out about what had happened, return to the hotel, and spend the better part of the day on the phone with their bank IN SCOTLAND trying to sort it out. So, yeah, maybe a little human logic is necessary in some situations.
I now ignore all correspondence and bills from our insurer until I get three on the same issue or visit, because that gives them enough time to sort it out among themselves without wasting my time.
As far as I know it has had no negative effect.
Did medical billing and insurance claims for a private practice when deciding whether I wanted to go to med school (didn’t, can’t stand non-compliant patients). The receptionist or the medical biller should have checked to ensure everything was in place before sending in the claim. But there are a few things that could have gone wrong: 1) some practices have an automated process set up so that all new claims are sent out on a weekly basis, if the medical biller wasn’t in that day the claims wouldn’t have been looked at before going out; 2) doesn’t appear to be the case here but the referral could have been sent in and misplaced (or “misplaced”) by the insurance company. Can’t tell you how many times I had to send things in 5-6 times before the insurance company would acknowledge receiving it.
The reason medical practices send in a claim so quickly is that some insurance companies (especially the crappy plans) have a narrow window during which claims can be filed. If a claim is filed within the timeframe and needs additional documentation the office can send in the documentation after the filing time period. If they wait to get all of the documentation and file it outside of the deadline they have to write off the visit.
Finally, sadly, there are quite a few people who use insurance cards that are for policies that are no longer in existence. While most offices determine coverage before your appointment, if they do not they want to get the claim in as quickly as possible so that if there are any shenanigans they can start trying to collect from the patient as soon as possible.
Although I hated the job I weirdly enjoy dealing with all of this stuff now. However, I never react to the first bill from the office or the first EOB from the insurance company. If you get something like this file it away or make a note of it somewhere. If you get another bill on the next billing cycle then take the time to start calling people. Really, you could wait a couple of billing cycles, but I’d only do this if you’re good at keeping track of these things. The credit reporting agencies wait 180 days before adding medical debt to your credit report so you have time to wait and let them get their act together.
I also love when cats vomit exactly on the other side of a door you will certainly step through, to ensure that you are 100% aware of the vomit, in the most in-between-toes sense possible.
Ugh. Insurance. Makes me SO MAD. All of it.
I am still so mad about insurance things like this from TWO THOUSAND AND THREE that I can’t have discussions about it without yelling.
My heroic cats a) puke where they have most brilliantly deduced I will step in it – no doubt so I notice it as soon as possible! and b) howl all night at the front door, I assume to scare away intruders. HEROES.
Before Lucy (our dog) was housetrained she used to poop on the front door mat right where the door would crush it while opening, seconds before the incoming person stepped in it. How do they KNOW?
My cat not only heroically and considerately always vomits on the carpet, she also makes loud noises before she vomits to give me time to grab a paper towel and put it under her heaving head. And THEN she does the superhero move of turning away from the paper towel and vomiting on the carpet near it, rather than on it, lest the pristine paper get soiled. She’s also considerate enough to vomit in a different place every time, I assume with the idea that eventually the entire carpet can be uniformly stained so I don’t have to shampoo it to get it back to a uniform color.
Insurance is a very hot button topic for me-my husband pays an unbelievable amount of money for myself and my daughter, and still-we have a $5000 deductible per person. So, I need an MRI on my knee, when I called imaging places to get an idea how much it costs-when I said I would be paying OOP, they said “well do you have insurance?”. When I said yes, they said, sorry-we can’t give you any kind of deal.
So I get to pay MORE money for the same procedure, but I have horrible insurance, that my husband pays a ton of money for. There is something really wrong with this. I am seriously considering having him take us off his insurance policy, and hope against hope that neither of us has a catastrophic accident or illness. I work as a substitute teacher, so I don’t get benefits-and my daughter is a college student. The only thing that keeps us on his plan is plain old fear-but I am so sick of insurance companies taking our money and giving us nothing in return.