Insurance Fun

So today have been filled with insurance! And for all of you out there who might not know what that means, I will explain:

First I have to call the hospital to see if the insurance was billed and if so why there is still a balance.

Then I find out by the hospital that they were billed but they denied the claim, saying that it was not an emergency. Okay, my husband was diagnosed with STREP and had a fever of 106, and doesn't have a primary care physician, nope that's not an emergency at all...

Then I have to call the insurance company to see why the claim was denied. They said because the hospital said he was seen for a sore throat, but the claim for his antibiotics went through... does that even make sense?!?... I mention that little fact to the woman, and she agrees that if it was only a sore throat he wouldn't of been prescribed antibiotics. She says to call the hospital and request the notes and diagnosis of the day, then to take those and fax or mail them to the insurance company along with a letter explaining what happened.(this woman was awesome by the way, sol helpful and she said  she wished she could just edit it, but she doesn't have that power, that they need documentation or that the hospital needs to refile it.)

So I call the hospital again, they say they need to transfer me to another department, no problem, so then I am talking to this other woman who tells me that they need my husband to sign a release of records before they can mail him his own records. Ummm, okay, I thought they were his records but okay. So I said he would stop in to sign it and pick up his records, but guess what?, they close a little before 5pm, my husband doesn't get home until 6:30pm and we only have the one car, so I cant pick it up for him so sign.

So she is going to mail us the release form that he needs to sign, then we need to mail it in to her, for her to mail us his records, so we can then mail them to the insurance company, all because the hospital said he was seen for a sore throat vs the strep he was treated for.

Oh and who charges 416.00 to swab for strep and talk to you for maybe 10 minutes and send you home, then also charge 100.00 for the strep test?!?  And then 80.00 in antibiotics... Thank goodness for Aetna and full coverage my husband has through work!

Good thing I had nothing better to do today then talk to people on the phone, its not like I had dishes to do, a house to clean, a dog to scold, or a baby to take care of.... And its a good thing my husband appreciates me! Haha!