Monday was quite a Monday. Along with my being sluggish and trying to find some momentum back to get some work done and help shepherd the kids on their way to their days, Erin and I both faced the kind of administrative struggles that one might expect to find in a Kafka novel.
My front was a call to our insurance company over a lab bill. This one goes back several months. Without going into gory details, the basics are that Erin’s doctor ordered some labs done, the lab she went to was in network for us, checked our insurance and said we’d have to pay in a about $150, max. A couple months later, we got a bill for almost 10 times that.
“Obviously a mistake,” I thought. So I called the lab, and they said oh no, the insurance company denied it. I called the insurance company and they blamed it on the lab. I went back and forth at least 6 times, literally getting a different explanation of why it wasn’t covered every single time. I finally got someone who told me it looked it was a coding error, and he was going to get with the dispute department at my insurance company and they were going to sort it out. I should just sit tight.
That was about a month ago, and sure enough, we got another bill for the same amount as before over the weekend. So once again, it was to the phones! I figured I’d follow up with the insurance company who would update me on their efforts and we’d get this settled.
I don’t know what caused me to approach the call with that level of naïveté.
After being on hold for almost a half hour, I finally got someone who almost laughed off my request and said “Oh, of course it isn’t covered. It was out of network.” I heard this schtick before and like before assured the person that the lab was in fact in network. From here it went back and forth I was eventually informed that oh yeah, the lab where Erin had her blood drawn was in network, but oh you see, for some reason the lab decided to have some of their tests sent off to a testing facility in Pennsylvania, and that facility ISN’T in network.
Obviously. Duh. It’s so obvious! Of course, we should all take the time to ask the in-network lab that just assured us about our maximum insurance contribution to verify further the place and people that might contribute to this process because lord knows if they will be in network or not.
By this time I had been on a phone over an hour, and I was furious. I insisted on getting connected with whoever was supposedly working on this for me, and no joke, the agent’s computer blew up and they had to call me back.
Thirty minutes later, I got a call back. The computer was working again, but yeah, no record of any call I had before. More, “well duh, of course this isn’t covered,” and “what’s a thousand bucks anyway?” from the agent. I pushed and finally convinced her to connect me with a manager. Once again, I was back on hold while they found a manager.
I was ready to brawl when the manager finally came on, but I was shocked to discover that she not only listened to my tale of woe, she empathized and agreed the whole situation was nuts. And even more surprising, she came up with an idea to apply for a waiver for this claim and get it handled. She put me on hold yet again and contacted the lab to work out the details, came back and said this should be resolved and we shouldn’t have to pay in anymore.
Of course, it ain’t over until it’s over, and I won’t rest easy until I see that zero balance bill, but at least I got some help, and she also gave me her name, number and a case reference number in case something goes goofy and we’re back at it again. I was at least relieved to have some resolution, but my god it took forever. Here’s me after the multiple-hour call.
Erin was also dealing with some fun with benefits, on Henry’s behalf. For months she has been working through an application process for a CES waiver, which is basically a government program to offer some additional support to kids like Henry, who are on the spectrum or have other special needs. It helps cover some items, equipment and care that isn’t covered by insurance.
I give her so much credit. It’s been a confusing and bedeviling process all the way, but after much paperwork and several phone calls, we finally got approved. Of course, that just means we are approved to file, which means literally another giant stack of paperwork, and a few more months of processing.
Erin worked much of the afternoon the endless application packet, and I did my best to help. There were times when I was reading these forms that I actually felt my mind twisting into pretzels. Somone along the way once mentioned to us that lots o families for whom English is a second language or who don’t have a very high level of education struggle with these forms.
I have an English literature degree and decades of experience as a writer and I felt like I was reading ancient Phoenician. The word salad on these forms was so twisted and circular, I felt like I was halucinating. I wanted to take the GRE again so I could clear my head with something easier.
We muddled through, but I left the entire day’s experience asking the very simple question…should it really be THIS hard and THIS expensive to get simple, basic medical care? Yes, Henry has special needs. But there are families who have much bigger and more complex medical issues. I can’t imagine how anyone deals with this nonsense when it’s this hard for us.
And this insanity and wasted hours with the insurance company and the lab certainly didn’t give me the takeaway of, “you know, I think the medical industry needs fewer rules.” Not so much. I’m frankly exhausted of having to spend hours arguing over crap like this.
So here’s hoping for some change one of these days. And that is a segway to another, happier bit of paperwork. Erin and I received our ballots over the weekend, and over a nice dinner of roasted chicken, we decided to do our research and fill those out.
Amelia asked what we were up to, so we took the opportunity to explain to her the importance of voting and doing our duty as citizens. We told her how proud we are of that right, and how vital is that we make our voices heard and advocate for what we care about.
She got excited about it too. She asked some good questions, made some sharp observations, and expressed genuine excitement about the fact that we could possibly have a woman as Vice President for the first time in American history.
It was a good conversation and we loved to see the enthusiasm and curiosity from our daughter. At one point she asked me if she could help me fill in the circles, and I figured I should pass on that offer. There’s probably a lawsuit somewhere to invalidate any ballots that have been touched by anyone not eligible to vote. I’m not taking chances. But Amelia stood by me as I proudly did my duty as an American citizen.
But we got them properly filled out, signed, sealed and ready to turn in tomorrow. It feels good to have that done. And we are a step closer to my favorite part of election season…the part when it is over.
