Here is my afternoon between the hours of 4pm and 5pm:
4pm - call our medical insurance company to find out why they 1) need notes every single week, 2) haven't paid a claim since mid-December, and 3) will be paying the aforementioned claims. Of course it isn't THEIR fault. It is our OT's fault because....GASP! She put two notes on one page. This was just way too hard for them to figure out. There were 2 dates....how would they know which note went with which claim.
Really? If you have a claim dated 2/6/10, and the TOP note is dated 2/6/10, and the BOTTOM note is dated 2/13/10....you really can't figure out which note to use??? Really?
35 minutes later, I have all the dates of service that they are missing notes for, and instructions for the provider.
4:35pm - called the provider, who got totally different information from her phone call. *sigh*
4:40pm - Insurance company called back to tell me they got 1/10 claims to be reprocessed. Yippee.....give them a gold star. I mean, 10% is quite an accomplishment, huh?
4:45pm - called the durable medical equipment company about the $200 bill I received. They look it up....and look at that.....we have a financial waiver. The bill was an error. Ignore it. OK....I will. Thanks for confirming what I already knew.
The insurance company is holding about $1400 worth of claims hostage. Of that, $200 is our co-pay. Our flexible spending account doesn't activate until the claim actually goes through, so we basically have been paying double for 2 months. Once out of pocket while contributing to the account, and once at the visit. Until the claim goes through, we don't get reimbursed. I would really like my $200 back, please.
The durable medical equipment people....I don't get them. We have had to deal with them for 7 years....I kind of know what I am doing in this arena. Why is it so hard????
Advocate for yourself, people!!! Advocate!!!! That is the rally cry of the day!