Tuesday, July 21, 2009

Healthcare Reform Pt. 4

I'm not a medical professional, I'm just a mom. A mom who has spent a lot of time trying to navigate through inefficient systems trying to get care for my children. I'm going to give you several posts related to many of the headaches I've had to go through in order to get care for my children.

Let me preface this by saying I have health insurance. In fact, I've had the exact same health insurance for the last 12 years from one of the bigger players in the health insurance game. I work for one of the largest employers in the U.S. and have what most think are the "best" benefits around. After reading through my posts, I wonder if you would say we are getting the "best" medical care available to a working family of 4.

Scenario #4:

When I had my daughter, 7 years ago, I had a very high risk pregnancy. I had lost a baby prior to getting pregnant with my daughter, had Hyperemesis Gravidarum and ended up going into preterm labor with her. So, imagine my surprise when I received a bill in the mail after her birth for the pediatrician who saw her in the hospital. Evidently, the insurance company denied payment.

Want to know why?

Ready for this?

It was denied because the pediatrician was not selected to be my daughter's primary care physician. The pediatrician was not selected as my daughter' PCP because the insurance company wouldn't allow me to officially select/add a PCP for my unborn child. Yes, I tried very hard to get her added prior to her birth. When I went into preterm labor, there were several things my OB suggested I do while laying on the couch 23 3/4 hours a day. This was one of those things.

Here's the kicker - I gave birth a few days before Christmas and got the bill (as a result from the denial) within 2 weeks of her birth. They never even gave me a chance to get her added even though I tried to take care of this before her birth!

Now, tell me this - what new mother who is trying to nurse and care for a brand new baby after being on bedrest for 6 weeks is thinking about which day during the Christmas holidays she can call and deal with the lovely, obnoxious representatives from an insurance company?!?!

No comments:

Post a Comment