Total AW insurance rant (this is familiar)

[bluefairy5]

Oh, PAIFers. May I treat you to a Blue Fairy novella?

Those who were around 3T in late October may recall I went on a big long rant about my insurance when my RE was suddenly out-of-network with no notification. (We're on a NY state Exchange HMO plan, since we own our own small business and no longer have the option to get a plan elsewhere.)

I thought my out-of-network troubles were over in moving to the OB. I had my initial visit today, they took a gallon of blood, copied my insurance card (which is in the hospital system's computer network already, so technically they already had it), and sent me on my way.

An hour later, I get a phone call. This OB is NOT in-network. The office has been all over BCBS to take her out of the in-network provider search results for MONTHS, and BCBS hasn't done jack about it. (This is not limited to BCBS, but it IS rampant in the Health Care Exchange plans, to go by this.)  I basically just started bawling on the phone.

After calling multiple practices who were either a. also listed incorrectly as accepting my plan, or b. not accepting new patients until May, I was able to find a different practice at another hospital (where MH had a positive surgery experience). The new new OB doesn't have great bedside reviews, but oh well, you can't win 'em all.

I know this isn't some huge world-ending problem in the scheme of things, but I just feel so drained and angry. I set up today's appointment a month ago because I wanted to have everything in place. Instead, today I enjoyed several hours' panic thinking I might not be able to schedule an NT scan at all because of an insurance thing that should've been discovered before my appointment.

And even though I know it's totally manageable, this whole day has felt really overwhelming. (Not to mention we're on the hook for this appointment now after all the extra OHSS appointments I had in the past month, totally OOP.  Great, thanks, BCBS.)

I just needed to word-vomit that out somewhere.  Please have a delicious ice cream sandwich for your time.

[Deleted]

Insurance companies can go eat a bag of dicks. They're the worst to deal with. I'm sorry they can't seem to get their act together :/ Hopefully the new OB does work out for you.

[ginnyjones82]

I hope everything works out with the new OB.

Insurance companies suck!!!

I am now very afraid of the NYS exchange. When I quit work, that is what I have to start looking at since DHs insurance is too expensive for the family plan, and he makes too much money for me and baby to get anything state funded. I am not looking forward to that at all!!

[lilyharper]

My DH works for a medical group and bcbs has been causing them nothing but problems. They keep telling the practice and the patients that they are in network...and then charge them. I don't see how bcbs is managing to not be responsible for the charges, but my DH's company has eaten a lot of the charges.

[IFinTN]

It seems like to me if you did everything right to verify that the services would be covered for your OB visit, then you should not be on the hook for all the charges. You gave the OB your insurance well in advance of the appointment. They should have verified your coverage beforehand. I would use this to your advantage in negotiating a better cash price for services rendered.

[hbanana18]

Definitely vent worthy! I hope your new OB works for you. What a pain in the ass!!

[bluefairy5]

Thanks for the commiseration, gals. I knew you guys would get the stress factor here, even though everything should be okay.

@dyork Maybe when/if we switch to another company than BCBS, my notification of cancelation letter will simply read "eat a bag of dicks."

@buttmonkey Yeah, I was really happy to be moving to her. Oh well. But my day has been made by your avatar!! Yay!!!

ginnyjones82 Stay as faaaaaar faaaaaaar awaaaaaaaay from the NYS exchange for as long as you can. I already AW'd it up all over the place so I won't go into gory detail, but it is NOT ideal. There are some good things about our plan, but the entire system was just so poorly executed.

lilyharper That's nuts. The sad thing is, I wish I could say BCBS was the unequivocal worst, but MH used to have UHC and it was the pits too, and not even when HMO-style.

firstbbq Yeah, I was able to schedule with her on 4/9 and NT scan is at their hospital on 4/15. So again, I didn't end up in a terrible spot, but the stress that I *could* have knocked me on my ass in a way it usually doesn't. I'm assuming that's a KU-related reaction.

IFinTN That's not a bad idea. I might try that if I can get my Big Girl pants on.

hbanana18 I hope she works too - her demeanor (to go by reviews) lacks a certain je ne sais quois, but we can't have it all, I suppose. As long as I'm not paying $13K before L&D, I figure I'll deal. (The approx OOP cost for the OB I saw today. Why didn't I study medicine?)

[bluefairy5]

Mar 20, 2015 17:15:14 GMT -5 bostongirl617 said:

I am sorry you had to deal with all that stress today, so unfair! Can you document that the provider is documented as in newtwork (screen shot of the website?) and appeal the charges?
Also if the new doctor is not what you need don't feel like you have to stay with her. You could do the NT with her and then switch when other doctors schedules open up.

That's a really good point re: not being stuck with her.  (I'm kind of a black-and-white thinker if I don't work at it.)

Regarding the screenshot, I do have them, successively over weeks while I waited for the appointment.  But in the fine print it they remove all blame from themselves by saying something like, "We make our best effort to keep this database updated [riiiiiiiight], but call the provider's office to confirm coverage."  So it's really the OB's office that fell down, since they had my ins. info right smack in front of their faces for a month.  And when I arrived today.  And also for a month.  

I will say, their in-network search results have two NYU OBs listed on E 84th.... NYU is on E 34th.  You google her?  She's on E 34th.  Unreal, this "database."

[sewfie2]

If you send them an EAD letter, please post it here too! That would be amazing. It's amazing what hoops ins companies will jump through to avoid actually doing their damn job.

[rachaeleigh]

Ugh. On one hand, I feel fortunate to have our medical insurance because other than IF coverage, it's pretty good.
On the other hand, my insurance can suck a bag of dicks....all of them

Sorry that you had such an overwhelming day (((hugs)))

[Smootiepie]

Oh gosh, sorry hon

[lilyharper]

You could always send them a care package from Here (NSFW) but not quite as bad as it sounds...

[bluefairy5]

sewfie2 What gets me is that they've been called out (along with all the other companies) for maintaining false listings for their Obamacare plans in order to make the networks look much more expansive than they actually are. Totally legit.

@ketchup I need me a pair of those pants for sure. Perhaps also a skirt, since spring is coming.

lilyharper LOLOLOL!! How have I been on the internet since 1995 and never seen this site??

rachaeleigh, Smootiepie, thanks for the hugs and commiseration

[dharmachick]

Blech. I'm sorry you've had issues with them again.

[DrHooch]

That sucks. I'm sorry. I hope the new OB turns out to be better than the reviews would have you expect.

[ProfessorChaos]

Ugh, so sorry. PAIF is stressful enough without insurance woes ((hugs)).

[bluefairy5]

dharmachick Right? Again.

DrHooch I figure I'll try to just go in with an open mind and assume the best unless proven wrong.

ProfessorChaos Extra stress indeed. I woke up this morning feeling like I worked out yesterday, so apparently I was sitting around with a bunch of my muscles all clenched up for several hours. Greeeeat.

Thanks again, everyone, for letting me get that OUT.

[tkb24]

Do you want me to find them? If a bunch of pg hormonal ladies showed up it might scare some one. I don't mind a trip to NY. You just let us know

[wazzu08]

Mar 20, 2015 15:48:21 GMT -5 @dyork said:

Insurance companies can go eat a bag of dicks. They're the worst to deal with. I'm sorry they can't seem to get their act together :/ Hopefully the new OB does work out for you.

+1 

I swear they intentionally trick you and make it impossible to read policies just so they can squeeze you out of even more money.  They win the asshat award.

[bluefairy5]

tkb24, LOL! That would be a sight!

wazzu08 Yup. They sure like finding any reason they can not to be helpful, and that's putting it sweetly.