I HATE INSURANCE!!!

Kellsie has bad feet/legs, we all know that. She had been seeing a specialist on feet and ankles from July 4th to end of DEC last year. He said they would have to do major surgery to fix her feet. He told us he didn't feel comfortable doing it and referred me to the children's hospital here. I called our insurance and verified they are in our network. I also checked their website and verified the same information. I then called the hospital to make the apt and verified with them that they do take Cigna.

I went to the apt on Jan 28th. I paid the 35.00 specialist co pay. The Dr looked at Kellsie for about 10 min and told me I had to see another Dr.

We took Kellsie back the next day, paid another 35.00 and saw another Dr. This Dr set us down the hall to get xrays taken (we brought our xrays from the prev Dr, but he did not take them right, so we paid money for them for NOTHING)! She said the inserts the prev Dr had Kellsie using were causing major problems and hurting her feet. She said Kellsie needed surgery on her legs, not her feet.

A month latter I get bills saying I have to pay 750 deductible (not my normal 250. in network). I called insurance, they said that children's hospital billed under UNM hospital not Carry Tingly Hospital so they would not cover at my normal coverage. WHAT??? SO I called the hospital and told them the problem, they would have to bill under the correct name. They will not! So I call the nurse person at the hospital who was setting up the surgery and she said she would work with her billing person to get ever thing worked out.

Ann (the nurse) called to give another date for the pre opt apt and I asked her about the insurance. She had not done anything. I told her the problem I was having and she gave me another number to talk to and see if they would re bill under carry tingle hospital.

I called the new number (the UNM business line) and they told me that Carry Tingle Hospital is covered by cigna, but the Dr.'s are not. Again, WHAT??? I told her I called everyone to verify that everyone was covered and they all said yes. But that doesn't really matter, does it. She said to call insurance and see if they would cover the Dr's under an umbrella clause.

I called the insurance and Dixi ( I am on first name basis with everyone at the insurance now) said that most of the insurance things have been fixed, because the name UNM Hospital that they originally billed was still under my in network plan (all this stress for what?). Then she tells me that I still owe money. WHAT??? The hospital billed those office visits at outpatient procedures. Dixi said they would have to re bill as Dr visits. She also said to get the procedure codes for the surgery and casting and call back and they would give me the amounts that I would be charged for the surgery.

I call the business hospital line back and tell them what the insurance said. She said she would have to talk to her manager. FUNNY!

I called Anne back, she gave me the procedure codes.

I called the insurance back. I gave them the codes, they said thank you. I asked them how much it is going to cost me and they can not tell me that information. That is even funnier. I tell her I just talked to Dixi and she told me to do this. But no, the hospital has to sub in writing the codes and authorization. Then the insurance will fax them back and tell them what they will cover and if they are in network or not.

So I call and leave a message for Anne asking her to get with Shirly (another billing person) and see if she can fax all that stuff.

So I didn't get anything done. I am still waiting on a call back from the person talking to her manager. And I have to wait to hear from Anne on if she can get shirly to do all the paperwork. That was 2 hours out of my day that I can never get back. And of course the insurance cannot call the hospital and work this out. That would be too much time on their part.

So, we might have to take a second mortgage out to pay for Kellsie's surgery, or we might only own 250.00 plus 20%, who knows. It is all a crap shoot anyways!

I need a nap. I need headache meds, I need some dang customer service! I need to go pick up the kids from school. Update you latter, or maybe not, it is all out of my hands!