Insurance paperwork gives me a headache

Feb. 27, 1995
I used to say my children were not allowed to get sick enough to need a doctor. We had insurance in case they did.

Last summer, my son broke the rule and spent a couple weeks in the hospital. His first day in the hospital, I passed the time talking with hospital billing and the insurance company verifying that his stay would be covered by insurance.

He left the hospital with a letter from the doctor advising him to not attend college in the fall. I sent the insurance company a copy of the letter with the first stack of medical bills.
A month later, the insurance company asked for verification of his scholastic standing. I talked someone locally who assured me he was covered.

The insurance company quit making payments to the medical providers because they needed proof of his status as a student or non-student.

I called the woman who approved the checks for our claims at the insurance office. “What do you need? ”
“Proof of his status as a student.”

I counted to 10. “OK, this is the second time I’ve done this, but I am stapling a copy of the letter from the doctor to your letter and sending it back to you.”

A couple weeks later, I called the insurance claim office to see if his bills were going to be paid. “No, we are waiting on the corporate office’s approval.”
I began checking his status every time I got another medical bill that had not been paid. The representative came to know my voice and my question without asking. After several weeks of calls, I asked for the name and number of the person who had to grant the approval.
Pressed for a reason why the approval had not been granted, the man said we needed certified letters from the college my son had attended and the one where he would be attending.

We had verified his enrollment in the spring, he had finished a year of college the month before his hospitalization, I had talked with the insurance company the day he went in the hospital – and they needed to know that he would be in school next semester before they would pay? I counted to 100 and called the colleges.

The college letter said he would be full-time student in the spring ’94 semester. Corporate headquarters said, “We assume this means ’95, but we have to wait until the college administration is back from their holiday break for verification before we can give final approval.” I looked at red “overdue” stamped on bills from labs, clinics, and hospitals.

I counted a lot more numbers than I knew before politely hanging up. The holiday break ended, my son went to college. I had to call the corporate offices and insurance company a couple times before the check writer had approval to pay. This month, I am finally seeing bills marked, “insurance payment received.”
I am reinstating the rule that no one is allowed to get sick in this family. I can’t count any higher than I did this time around.


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