Wednesday, August 20, 2008

grrr, insurance bills

today i received a bill for $118 from the hospital (where i work). reading it over, i found out it was for 'cytology' during my annual well-woman exam (gynecology nurse practitioner) on 7/1/08. the only thing i had done was a regular pap smear and exam (that part was covered). found my explanation of health benefits form & it said the reason it was denied was that testing must go through my pcp or co-care provider. my np is my primary & if your gynecologist isn't a "co-care provider" then who is? it was covered last year (6/28/07, so it didn't overlap) & why would an annual well-woman exam be covered, but not that testing every year?
and to think, i want to become an insurance claims/biller/coder. i'll be calling bcbs tomorrow and find out exactly why this is a problem and if necessary contact sue (my np) to either resubmit or fight this. i'm almost 30. having an annual pap is preventative for more expensive conditions that insurance would need to cover; you'd think they'd want to avoid paying for treatment for dysplasia or cervical cancer or something.

today i also had my 7 week remicade infusion. totally flipped out on s this morning because i was worried about having an allergic reaction again. this pretty much exacerbated all the other worries & insecurities in my head, so i let it blow all out of proportion. got upset about not knowing exactly what's happening in my life (work, love, etc) & i feel like i'm forcing myself on s to spend time at his house. at 7am s was the only one who was there to vent to, so he took the brunt of it.
i only broke out due to the benadryl & zantac (who knew that stopped allergic reactions, too?). yes, i had a reaction to the drugs that keep you from having an allergic reaction! where the iv entered my arm, all the veins were inflamed like a spiderweb up to my elbow while the drugs pumped into my system. it was weird & my arm felt cold to the touch in that spot (inner forearm below the elbow.) it went away before they started the actual remicade and i didn't break out in hives this time. not sure if it was the zantac/benadryl combo or the fact that they only infused it at 60ml/hr at the fastest. i broke out last time when they upped it to 80ml/hr.

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At 8/20/08, 9:29 PM, Blogger Suebob said...

Every single year my OB GYN codes my annual exam as an office visit, which means it is billed instead of covered 100%. Every year I forget to tell them in advance, because I assume they will KNOW the annual exam is the annual exam...I hate insurance billing, I do. I wish there was a way to make it all better.

At 8/20/08, 9:45 PM, Blogger mar said...

what a hassle!
i'm sure i'd forget to remind them while i was in there every year. i'm distracted enough during that appointment as is.

At 8/21/08, 8:16 AM, Blogger super des said...

Isn't it fun to let your emotions take over & blow up over everything that was released by one thing?
Oh wait, no that's not fun. Our poor boys have to suffer for it.

At 8/21/08, 1:15 PM, Blogger mar said...

well, at least my chat with bcbs was only about ten minutes over my lunch break and the lovely cs rep said she'd resubmit it and i should get a new explanation of benefits with the correction, which i assume means that it's covered.
and s was in a horribly rage-y, grouchy mood a couple weekends ago & i had to put up with that, so i figure we're almost, kinda, sorta even.

At 8/22/08, 3:16 PM, Blogger Suzanne said...

I figured that once you called, they'd fix it. It would be nice if people could just get it right the first time, though. "Little discussions" with health insurance took up way too much of my time a few years ago. Lately, I haven't seen many docs (kenahore - Yiddish for "knock on wood"), so I've been happily free of insurance insanity. I'm waiting to get the paperwork for the unnecessary MMR vaccine, though. That'll be fun.


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