Success. . . ?
May. 27th, 2003 10:20 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
bronwynrhWell, that's what I'm told, at least.
I was outside the MegaDeath office at 8:30 this morning where I stood for half an hour, waiting for the door to open. Eileen walked up at precisely 9 o'clock.
(I marvel at people with 9-4 jobs. . . especially those who have lunch hours from 12-1 to boot. Absolutely amazing!)
Anywho, she invited me in and we sat right down and I started to explain what had been happening since my first visit to the neurologist in December. I showed her the multiple bills, the statements of benefits that showed how Mega had consistently gone against its own set precedent, repeatedly failed to do what its representatives had told me they would do, and finally were failing to follow the letter of their own policy.
I then told her that my doctor had sent a bill suggesting that I would be sent to collections if a remaining balance were not paid.
Eileen is a Mega employee, so there really is only so much she will be willing to do, I suppose; however, in my experience with her over the past 4 years, she's also been able to work as an advocate, insofar as she is able to call the right people and push things through in a pinch. Sometimes.
I don't want to count my chickens, but it seems that today she did it again. She called the claims adjustor and asked that they pay the balance. Now.
*cross fingers*
Next call, the doctor's office. I reminded my doctor's receptionist (and SIL) of all those things I've done to make sure they get paid and asked why they felt it necessary to dun me. . . Answer: The computer automatically adds that message after some period of time, she's very sorry, she knows and understands the trouble I've been through and no, they are not going to send me to collections now.
My internal response? Take a little more control over your billing so you're not scaring the crap out of people - these are people with neurological disorders, after all. I did say something a bit milder and more personal. . . she got the point, though.
Moving on, I suggested that the problem will continue unless the doctor chooses to do one of two things: 1. enter into a contract with Mega or 2. lower his fee to Usual and Customary. Either one of these solutions would end the billing problems and the massive waste of my time arguing with obstinate HIPAA-blocked "customer service" representatives. Otherwise, I have to consider finding another doctor, based on bargain-hunting or a Mega-determined list (non-local only, I'd have to drive to Indy for all my appointments).
Obviously, I'd rather keep my current physician. Here's to hoping he makes some smart decisions.
And just so y'all know (those of you who may think I have anger issues ;-D), I did it all with grace and good manners, but a no-nonsense attitude that says I know my rights and will not be messed with.
The rest of my day. . .
I stopped by the lab to chat with Clay for about a half hour or so, and then I made a mad dash outta there! Grabbed a small coffee and a chocolate-cream cheese muffin at Starbuck's and headed home to enjoy them outside on the back patio with my book (Scandalmongers by William Safire for you bookish folk). I managed a two hour nap and a lot of reading and a whole lot of relaxation today.
And it was good.
I was outside the MegaDeath office at 8:30 this morning where I stood for half an hour, waiting for the door to open. Eileen walked up at precisely 9 o'clock.
(I marvel at people with 9-4 jobs. . . especially those who have lunch hours from 12-1 to boot. Absolutely amazing!)
Anywho, she invited me in and we sat right down and I started to explain what had been happening since my first visit to the neurologist in December. I showed her the multiple bills, the statements of benefits that showed how Mega had consistently gone against its own set precedent, repeatedly failed to do what its representatives had told me they would do, and finally were failing to follow the letter of their own policy.
I then told her that my doctor had sent a bill suggesting that I would be sent to collections if a remaining balance were not paid.
Eileen is a Mega employee, so there really is only so much she will be willing to do, I suppose; however, in my experience with her over the past 4 years, she's also been able to work as an advocate, insofar as she is able to call the right people and push things through in a pinch. Sometimes.
I don't want to count my chickens, but it seems that today she did it again. She called the claims adjustor and asked that they pay the balance. Now.
*cross fingers*
Next call, the doctor's office. I reminded my doctor's receptionist (and SIL) of all those things I've done to make sure they get paid and asked why they felt it necessary to dun me. . . Answer: The computer automatically adds that message after some period of time, she's very sorry, she knows and understands the trouble I've been through and no, they are not going to send me to collections now.
My internal response? Take a little more control over your billing so you're not scaring the crap out of people - these are people with neurological disorders, after all. I did say something a bit milder and more personal. . . she got the point, though.
Moving on, I suggested that the problem will continue unless the doctor chooses to do one of two things: 1. enter into a contract with Mega or 2. lower his fee to Usual and Customary. Either one of these solutions would end the billing problems and the massive waste of my time arguing with obstinate HIPAA-blocked "customer service" representatives. Otherwise, I have to consider finding another doctor, based on bargain-hunting or a Mega-determined list (non-local only, I'd have to drive to Indy for all my appointments).
Obviously, I'd rather keep my current physician. Here's to hoping he makes some smart decisions.
And just so y'all know (those of you who may think I have anger issues ;-D), I did it all with grace and good manners, but a no-nonsense attitude that says I know my rights and will not be messed with.
The rest of my day. . .
I stopped by the lab to chat with Clay for about a half hour or so, and then I made a mad dash outta there! Grabbed a small coffee and a chocolate-cream cheese muffin at Starbuck's and headed home to enjoy them outside on the back patio with my book (Scandalmongers by William Safire for you bookish folk). I managed a two hour nap and a lot of reading and a whole lot of relaxation today.
And it was good.
![[identity profile]](https://www.dreamwidth.org/img/silk/identity/openid.png){kind=small}
(no subject)
Date: May 27th, 2003 10:15 pm (UTC)Given the reputation of what ML does to people's sanity, I don't think anger issues would have entered into this at all. (;
I, personally, have given up any hope of ever getting my claims reimbursed to me. (The health center charges ME and then makes ME sort it all out with the insurance... HA!)
(no subject)
Date: May 28th, 2003 09:30 am (UTC)(no subject)
Date: May 28th, 2003 09:02 am (UTC)You're one hot mama! Bramey, you're my hero! ;)
(no subject)
Date: May 28th, 2003 09:28 am (UTC)