Saturday, November 17, 2012

Doctors appointments and insurance companies- UGH!!!!!

Okay I'm sorry about this rant but I need it!!!! Okay let's start with insurance companies- they are a necessary evil; and yes I'm very thankful for the insurance that we have (and pay dearly for)! With that said, can they PLEASE do their job, and do it right!!! H sees an OT once a week; this OT doesn't take insurance so we have to take care of the billing which I thought wouldn't be that big of a deal- so wrong! First of we have what is called a "gap exception" because this provider is out of network so each month that I fill out the paperwork a d submit the bill along with the paperwork I have to include the gap exception number on each form which I do, and highlight. Each month I have to call the insurance company to find out where the check is, because each month they file it as out of network and applied to our deductible! Now tell me why I put the gap exception # and highlight it so it's very visible??!!! I asked them what can I do to not have to call every month and do you know what they told me, nothing I'm doing everything I'm suppose to do and apparently someone there isn't! To top things off we never get paid the same amount and I've asked why and they said they "discount" it?! What the?! Ugh so very frustrating!!!
Another rant about insurances, went to pick up my test strips for the month for my blood glucose monitor, and about fell over when they told me they would be $120!! Apparently the insurance co had decided to change my test strips to a non formulary drug whatever that means so they will only cover a small portion of these strips (pharmacist informed me that insurance co can do this as much as 3 times a yr!). So I had to get my doctor to order a new monitor that takes different strips that the insurance company would cover. The new strips for the month and my new monitor came to $60, half of what just the strips were going to cost me. Oh the hoops we go through!!!!
Now my rant about my OB. I LOVED my experience with this OB last time however this time around has been less than desired . I think because last time I didn't start with them until I was 12 wks along. I've gotten nothing but the run around this time. It took me almost a week just to get my ultrasound scheduled! I would call scheduling to schedule it, they would say there wasn't an order so they would send me to the nurses desk, where I would have to leave a message, nurse wouldn't get back until 5 pm or after, and scheduling would already be gone! Finally got my ultrasound scheduled for November 29th (a day before our 10th wedding anniversary). However my appointment for labs, meet with the doctor etc isn't until Dec 14th?! It's suppose to be around 6 weeks but it's scheduled at 8 or so weeks. Anyhoo I'm hoping to get it done sooner, once I have my ultrasound.
So now I've developed a rash, very similar to the rash I had when I was pregnant before with L, except it didn't start this soon. It's on my stomach, legs and arms- its small red itchy bumps (before I was told I had pupp). So I called the OB's office first thing Friday morning (8am)left a message for the nurse explaining what was going on, and should I be concerned etc. Do you know they did not call me back till 5:25pm!! The nurse proceeds to say well since its so late, just use 1% hydrocortisone cream; take benadryl every 6 hours (um how is that going to work, when I'm already tired and have 3 kiddos to take care of?!). If it doesn't help or clear up in 48-62 hours call your regular physician or a dermatologist. So now basically I feel like I've been "labeled" a problem patient and they just don't want to deal with me. I hate that, all I want to know is, is it going to hurt the baby!! Once again very frustrating, I'm scared as it is, so afraid of losing this baby, and the doctors and nurses don't seem to understand that.
Okay, okay enough ranting. I'm looking for a peaceful and hopefully quiet weekend at home with not much planned before the craziness of the week begins. M has two days school and H is out of school all week:) M's cheer leading practices begin this week - Mon and Tues nights 6-7pm; H has basketball practice Mon nights 5-6.  Then the holiday fun begins. Hope you all have a fabulous weekend!! THANK YOU again for all the love, support and encouragement!!


  1. Is H under 3? If so check out your states early intervention program. LM gets OT through them.

  2. No H is not under three. Thanks for thinking of us though. I'm very familiar with the "first steps" program in our state. Before M was born I worked as a developmental interventionist.