Wayback Wednesday – Insurance Woes

Picture of my hand with a BG line chart in the backgroundCourtesy of the “Wayback Machine“, I bring you the early entries I made in my online diabetes journal.  This was back before Blogger made things easy, and I had to write the entries in HTML.  The journal is no longer available, but thanks to the wonderful tools available on the internet, I was able to find much of my old stuff.  I’d like to share one of the old entries with you.

Does insurance stuff ever get easier?  Seems like it is the same types of struggles now as it was back then…

03 Mar 2000

Well, I’ve been on the phone with my insurance company (BCBS of MN), and so far have been incredibly disappointed in the coverage I have. For the ambulance visit (keep in mind I did not actually go to the hospital..), I need a doctor’s referral (??!!!?!!), otherwise I’m charged with a $300.00 deductible. Then they will cover 80% of the allowed amount. So, I call my doctor’s office, and explain the situation. They say the my doctor is out until next week, but that they would leave a note for him to check out. They advised that I ask my insurance company to delay the processing for a week until my doctor had an opportunity to review the situation. So, I call BCBS, explain the situation, and ask them to not process the claim for one week. They said that they could not. They would reject the claim, and after my doctor issued a referral I could ask them to try to adjust it.

Last time I saw my doctor, we spoke about motivation. That is where my problem is – motivation. I know enough about the tools, and how to use them – it’s all a motivation problem. My doctor referred me to a diabetic psychiatrist at the IDC. I was excited! I figured this was at least a step in the right direction!

So, I call BCBS to see what my coverage was. I was told that if the person I wanted to see was a
plan participant, they would cover the first 10 hours at 80% of the allowed amount, then between 10-40 hours at 50% of the allowed amount, with a pre-authorization. Ok, now I had to find out if the guy I was supposed to see was a plan participant – which he is not. Now BCBS refers me to some BHSI
company, apparently a group of plan participant psychiatrists. I called them to figure out if they had any “diabetic” psychiatrists – which they do not. Back to BCBS. I ask them what my options are now? I have to get a referral to an in plan diabetic psychiatrist, from BHSI (keep in mind I have a referral from my doctor to the guy with the IDC…). I haven’t called them back yet. I need to cool off a little first…


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4 thoughts on “Wayback Wednesday – Insurance Woes

  1. Back in ’97 I think, an ambulance paid me a visit. I don’t recall now if it was a time I took a ride to the ER or not, but I remember spazzing on the phone with the insurance demons because they said the ambulance should have been pre-certified
    The behavioral health part is especially infuriating because sometimes you need to see someone who has a more specialized expertise or you just need to see someone with whom you ‘click’, but if they’re out-of-network, you’re automatically screwed.
    I know I should feel grateful to have insurance, but I think they’re despicably evil nonetheless.

  2. I’m starting to think that insurance companies have a dartboard and when you call them, they throw a dart and say whatever’s on the spot, whether it’s true, or not. Or maybe that’s just mine.
    I filled out that claim form! Well, actually it was two, because each form only has spots for four items. First, the form has spaces where you’re supposed to write the prescription number, except the number won’t fit in the spaces. Then it has some spaces for a pharmacy number that no one (including the pharmacy) has heard of. Oh, and it makes sure to tell you if you leave anything blank, your claim will be denied. But my favorite part was where the address you send it to won’t actually fit on an envelope. So…think they did all that on purpose? 😉

  3. I was just talking to my sister about how you would think with the 715.00 a month I spend that I could get someone to help me out and not send me in circles. I hate it.

  4. Certainly sounds like – same song different verse to me!
    And I think we all could also write a post like this one. I have a pretty good one about having Walgreens prescription coverage, going to a Walgreens pharmacy, and having them be unable to find my insurance in their system. A fabulous $107.99 for a bottle of insulin.