…… GRRRRRRRRRR.......FREAKING INSURANCE COMPANIES!!!!!!

[day late]

Sorry. I just need to vent. Mom is 92. She has health problems. No surprise. I just got three phone calls from her health care provider, literally one after the other.

The first one was just 'Can I speak with Mrs.***?' No. She is in Ocala and I'm in Gainesville. My brother is with her right now, please call him. Here's his number and name.

NO SOONER than I hang up, that I get another call. 'We don't have the proper paperwork for your mother, so we have to cancel her appointment for tomorrow.'

I was trying to call my brother when the phone rings again. "We have the right paperwork for your mother so her appointment for tomorrow is a go."

STUPID FREAKING INSURANCE COMPANIES!!!! With all the money they make you would think that they could afford to hire people who know what they are doing. I am so PIS*ED at them right now.

 

[Peachy]

I sympathize with you. Hate to tell you it's not just the insurance companies that are stupid!

 

[hiwall]

That is the world we live in now. Almost every business is the same deal.

 

[Bob the Builder]

Injured 18 November. So far two bills for copay on insurance. $60 and $62. Total bills will run to the $60,000. Can't get anyone, hospital, doctors or insurance to give me an estimate how much I will owe in total.
Ruined Thanksgiving, Christmas and everything since due to lack of knowledge on total bill. Can't go anywhere can't do anything that will cost funds i may not have.
GD insurance and hospitals.
At least with most businesses you have an idea of cost and can budget or pass on by.

 

[Cyclonemom]

The insurance company might have the right people hired, but they have to actually SHOW UP TO WORK. People just don't want to work anymore, and not just in insurance.

 

[saeurs]

The 8nsurance ci.pany might have rhe right people hired, but they have to actually SHOW UP TO WORK. People just don't want to work anymore, and not just in insurance.

I don't want to work anymore, but my sense of integrity wins over my laziness every time. I guess I have to lower my standards.

 

[Cyclonemom]

I don't want to work anymore, but my sense of integrity wins over my laziness every time. I guess I have to lower my standards.

I prefer to think of the hard workers as Going Galt to be productive in other ways, vs just giving up like the current work ethic dictates.

 

[saeurs]

I prefer to think of the hard workers as Going Galt to be productive in other ways, vs just giving up like the current work ethic dictates.

Indeed. We are VERY close to paying off the house and that means we can work for ourselves much more. Looking forward to getting more projects done around the 'stead.

 

[kyrsyan]

Actually, that's not her insurance provider. That's a doctor's office that needs better organization.

When I was going through stuff, my insurance would say one thing and the doctor's office would say another. It got to be several levels of insanity so I finally called the insurance company. Especially because I had my benefits book and it didn't say anything about requiring all the extra referrals and prior auths that the doctors' office was insisting that my insurance wanted. The insurance rep actually handled it for me. She reached out to the doctors' offices and got the mess sorted out. I was actually surprised.

 

[Meemur]

Oh, I went through a bunch of crap from the office when I had my cataract surgery. (NOT the doctor or medical team). If I had been that disorganized and rude when I was a secretary, I would've been fired. My insurance agents weren't any better. Total bunch of Bozos! You're not alone!

Yep, we're back in the 80s in Michigan: no one wanted to work and things were always getting screwed up. I so hate having to deal with hospitals, insurance, or large companies in 2024.

 

[WildDaisy]

It sounds like they were trying to get your brother, like you were, and got no response, so they called the other number they had on file for your mother, you.

Caring for an elderly parent is a full time job, in itself. Couple that with medial issues and it can be overwhelming. I'm sure brother is doing the best he can keeping it all organized and didnt mean to have them annoy you.

 

[Publius]

Wife is dealing with a bank with her mother who died in May of last year and going around and around with them, She had to close a checking account because her parents years ago had setup automatic payment to a few organization's and trying to make it stop as both parents are now dead and the only reason for keeping the account open is paying taxes with checks that have their names on them.
On top of that the bank decided to call a living trust account (not the checking account talked about above) a business and now want to charge $15 per-check written from the trust account, and I'm thinking that would bankrupt most any business quickly it took two days to get them to understand it's not a business.

 

[anna43]

A lot of time the referrals or tests required are due to Medicare rules. My late mom's doctor told her she needed her gallbladder removed. It took six months of various referrals and tests before Medicare would allow the surgery.

My dd's doctor wanted to try a special medication for her and her insurance company kept requiring one thing after another and kept refusing. Dd finally called the insurance company and asked them directly if they were ever going to approve the medication. They hemmed and hawed but the answer was no. She got the medication through the company that produces it -- unfortunately it didn't work but that was a wasted 18 months where she could have moved on to a new plan or medication.

A trust account would have an EIN number which might be why the bank considered it a business. Without opening a probate estate and having an executor appointed, it can be extremely difficult to impossible to deal with a deceased's assets.

 

[dioptase]

I've been trying to get a prescription (for a muscle relaxant, for severe tension headaches, that I've been taking for DECADES) refilled. Background, I was on private insurance until I went on Medicare about 1.5 years ago, and in addition to basic Medicare I have a Medicare Advantage plan.

I talked to the pharmacist today to find out what the hold up was (after first going back and forth with my (new) doctor's office, who swore that they put in the prescription refill). It turns out that the pharmacy (without informing me) had put the prescription "on hold", because suddenly "insurance" (whether this be Medicare Part D or the Advantage Plan) refuses to cover the prescription. What? GRRRRR. They'll allow me to pay for it out of pocket (which I can do), but I am really annoyed. (It's about $95 for 30 pills; thankfully I only need a few a month.)

So now I have to figure out who/how to appeal this non-coverage.

And that raises the question about what if you need some REALLY pricey medicine... and "they" decline to pay for it.

 

[Elza]

Insurance is nothing more than a legalized racket backed by the government.

 

[ginnie6]

I'm going to 2nd that its the Dr's offices! Friend's dh needs shoulder replacement. The ortho told him it would be within two weeks. It is that bad. Nearly a month later no surgery and no appt. He's been calling and calling and chasing his tail trying to get them to do their jobs. I finally called dd who was an office manager in the healthcare system here and got advice from her. I called my friend back and told them to politely call the office tell them the fax was unnecessary that all they had to do was upload it to his files and that if they couldn't do that he had a number to call for patient resolution. All his paperwork was sent to the surgery co-ordinator while he was on the phone.
DD says every practice here in the system is short staffed. They don't have enough people to do what they need and the ones they do have don't want to work. She says someone dropped the ball and they were just covering. This and her baby are the reason she never went back after maternity leave.

 

[CaryC]

I love my doctors but different doctors office personnel really need to be educated and graduate from junior high.

And insurance companies.

And pharmacies.

And computer companies.

 

[colonel holman]

I'm going to 2nd that its the Dr's offices! Friend's dh needs shoulder replacement. The ortho told him it would be within two weeks. It is that bad. Nearly a month later no surgery and no appt. He's been calling and calling and chasing his tail trying to get them to do their jobs. I finally called dd who was an office manager in the healthcare system here and got advice from her. I called my friend back and told them to politely call the office tell them the fax was unnecessary that all they had to do was upload it to his files and that if they couldn't do that he had a number to call for patient resolution. All his paperwork was sent to the surgery co-ordinator while he was on the phone.
DD says every practice here in the system is short staffed. They don't have enough people to do what they need and the ones they do have don't want to work. She says someone dropped the ball and they were just covering. This and her baby are the reason she never went back after maternity leave.

Our local medical center group announced hundreds of millions in losses due primarily to widespread lack of staff at all levels. Business activity has devolved to utter chaos. MDs have left due to corporate pressures to over produce in the presence of essential staff, plus insurance paperwork webs designed to defer care. RNs have left due to the severe stresses that impair patient care, plus covid mandates. Support staff have disappeared due to society-crushing covid actions. All this on top of healthcare was already collapsing prior to the covid world. I needed an immediate critical biopsy for a rapidly growing tumor. That was first week of January. I will finally be getting that on Friday. And will pay for it myself since my insurance cant get around to approving it due to their own lack of staff. Can’t wait to see the clusterfuq I will face to get the likely radiation and surgery, as quickly as possible. Wife waited six months to get her hip replacement that was needed ASAP (back in Sept) due to the affected bones actually dying… due to the same issues. We are all so screwed.

Meanwhile my clinic and most clinics are now facing months of zero reimbursement income due to widespread computer hack destroying the nation’s largest medical billing clearing house. That will kill off another crop of providers in coming weeks/months

 

[Griz3752]

Injured 18 November. So far two bills for copay on insurance. $60 and $62. Total bills will run to the $60,000. Can't get anyone, hospital, doctors or insurance to give me an estimate how much I will owe in total.
Ruined Thanksgiving, Christmas and everything since due to lack of knowledge on total bill. Can't go anywhere can't do anything that will cost funds i may not have.
GD insurance and hospitals.
At least with most businesses you have an idea of cost and can budget or pass on by.

I may have read or heard this wrong but my impression was Hospitals are required to provide anticipated cost pre-procedure

 

[WildDaisy]

I may have read or heard this wrong but my impression was Hospitals are required to provide anticipated cost pre-procedure

Only if uninsured. It is called a Good Faith estimate and is provided to uninsured patients.

If you are insured, you are provided a Summary plan Description once a year usually around open enrollment time. It tells you what is covered and what isnt and what if any copay is required in a table by service type. You can call your insurer and ask for a copy if you dont have one.

 

[Bob the Builder]

This could well be the case for elective care. But for transfer from small town hospital and transfer to admit from the emergency room at trauma center for flail chest 9 broken ribs, fractured clavicle and punctured lung there is no way to estimate a figure.
Worst case scenario costs involving surgeries to fix the above sure but not until the issue arises.
You just take what comes and try to heal with the least medical involvement possible.
For sure it will be my last ambulance ride. $2400 for a taxi ride and absolutely no care given is a travesty.