I swear, this isn't a lecture. It's a reminder to myself that as much as I seemed justified in the moment, I did a rude thing today. I'm a bit ashamed. Apparently, I'm sharing that shame here because frankly, I need to vent about the whole incident. I need someone (anyone) to know what might make me sink to being rude.
Let's take a small step back and say that I've absolutely had it with insurance companies and medical billing in general. Every year during annual enrollment, when it's time to pick medical benefits, D plugs in the costs into a spreadsheet to figure out what is most cost effective for us as a family. Despite knowing that I was pregnant, I let him talk me into a high-deductible plan this year, even though I knew a co-insurance plan would be a lot easier to handle with all the medical bills ahead of us. (He wasn't willing to sacrifice cost for convenience, but I sure as hell was.) And while it's not all bad (we had that kind of plan last year, and it worked out fine), it's been a headache with all the medical bills that have been incurred, especially since late June. I've made several phone calls over the past eight weeks to doctors' offices and the insurance company to resolve concerns I have. Often I get an explanation that resolves the issue, and while I'm not always happy with the amount I have to pay, at least I understand.
Today, I did not understand.
(I still don't understand.)
It started with an Explanation of Benefits (EOB) from the insurance company that arrived in the mail a couple of days ago. It didn't seem unexpected at all. DM made a daredevil move out of my in-law's kiddie pool onto their back deck a few weeks ago, and had to be taken to the doctor's office unexpectedly to make sure he didn't break his nose (thank God, he didn't). So I knew that I was getting a bill from the pediatrician. I expected that bill. It wasn't until this morning, while eating breakfast, that I happened to glance over and realize that this EOB was not for DM, but for EM. What? He hasn't been sick. Not once. We're 100% covered for well-visits and immunizations. Why is the insurance company saying I owe the pediatrician money for EM?
So I called the insurance company and they explained that the pediatrician must have billed it incorrectly. Ok, no problem. I'll just call the pediatrician's office and get the matter corrected.
This is where things got a little hairy.
When the medical billing assistant got on the phone, I asked why I was being charged for EM's 1-month well-visit that my doctor insisted I have.
"It's not a well-visit. It's a weight check."
"I don't understand."
"We're making sure the baby's weight is ok, so it's not a well-visit."
"I have a scale at home. I can check if his weight is ok. Besides, he's huge, I know he's gaining weight appropriately and not underweight."
"Well, he needed to come in for immunizations anyway."
"Exactly. It's a well-visit."
"No, it's an office visit. We've billed you for this for your other two children, and you never had a problem before."
"That's because I never knew what I was being billed for before, and I was blindly paying you what you told me I owed. I'm bothered by it NOW!"
We went back and forth like this for a while. A long time. Too long. She basically just kept insisting that the required 1-month check-up is, in fact, a sick visit. I kept insisting that he was never sick.
Now, here's what really bugs me about the whole thing. If I knew up front that this was not a required check-up, as it's presented to the parents, then I would have said, "Heck with that, I'll see you at the 2-month well-visit." However, as the woman said, "He needed immunizations." Of course, he did. And I'm not an idiot. In order to properly measure the amount of medicine to administer to a child, they need to know his weight. (I may not be in nursing school yet, but I know that it could have serious negative impacts if a vaccine isn't administered properly.) It's a Catch-22 for the parents. It would be perfectly within my rights to say "screw the weight check," but then my son wouldn't get his immunizations, which I'm not willing to sacrifice. And in order to get his immunizations, they're calling my son sick in order to check his weight, even though he's not sick! And that means I have to pay when I shouldn't have to pay. They're basically pitting my child against my wallet, and my child is going to win every single time and my wallet will always be sacrificed.
So obviously, I was starting to get upset. (I'm still upset thinking about this Catch-22. I will probably be upset for a while at how tricky and deceitful this is.)
But I was trying to keep my emotions in check and get the issue resolved.
So I asked the woman, "So what can you do for me?"
I wasn't talking about money. Hell, I already sent in my payment for this bill (like I said, I thought it was for DM, not EM, so I had no problem paying it). And it wasn't a large bill, mainly because we met our high deductible with the birth, so co-insurance was kicking in. But it would have been a large bill if we didn't have that insurance. And there are other parents who probably get this large bill all the time because they don't have insurance.
I wanted an acknowledgement that it was a bad policy. And, as naive as I may be to hope, that maybe things needed to change.
But the woman got increasingly snotty with me. It's hard to convey tone in text form, but she was beyond rude to me. I was half expecting her to tell me to F-off at any minute.
"I don't know what you expect from me. It's not a well-visit; it's an office visit, so you owe us. I'm not offering you anything."
"It's a bad policy. Please tell me you understand why it's a bad policy!"
"It's the recommendation of the Academy [I imagine she meant the American Academy of Pediatrics], and it's been in place for years!"
And I admit it. I was rude. When I realized I was getting nowhere with her after ten minutes arguing on the phone, and I was going to be in tears any moment, I quickly said, "Well, this is complete bulls---. Have a GREAT day!" as sarcastically as I could, and slammed the phone down.
I'm mad at myself for stooping to her level. I feel embarrassed that I might run into her when I have to walk into that office for EM's 2-month check-up next week. I can truly imagine that my kids' file now has a label next to it saying something like, "Mom is crazy and hostile."
But it's a crappy policy. I will testify until my dying day that it's a crappy policy.
I just wish I knew how to get them to admit it, too.