Having Health Insurance Is Hazardous To My Health!

As many of you know, we had a beautiful baby girl a month and a half ago.  As with any change, a new baby has meant that everything has changed.  While there are challenges, they’re all worth it for those beautiful moments that only a newborn can give you, a soft sigh, a little breath, or a touch of wonderfully soft skin.

One area that hasn’t been amazing has been the health insurance.  As with anything major, the cost of having a baby is pretty high.  There are insurance claims upon insurance claims.  The ironic part is that keeping on top of all the insurance claims have been a source of more stress than actually having a newborn!

Consider this:

Adding our baby was pretty simple.  HR walked me through the steps I would need to go through to add the baby to our insurance plan.  The plan wasn’t changing, since we were already on family coverage anyways, it was just adding her to the plan.

Simple enough, right?

It seemed so when she appeared on the website after I logged in a couple days after providing HR the information.

Smooth sailing, except that all of the claims associated with her delivery and hospital stay were…

Rejected.

Huh?

I talked to the insurance company and they said, “Well, it’s because you haven’t responded to the form we send out which makes sure that she isn’t covered by any other insurance plan.”  When I pointed out that I had just added her a couple of days ago and there was no possible way that I could have gotten that form and responded to it, the nice lady said “Oh, yeah, it probably hasn’t even gone out in the mail yet.”

Double huh?!?

At least she was nice about it.

She explained that the system that tracks the responses only provides a Yes/No as to whether this information has been provided.  If it’s no, the claim is rejected.  There’s no date stamp or any other flag that could at least give the customer a chance to receive the form and mail it back.

Luckily, the lady was super nice and she was actually able to enter my responses into the system on the phone, and submit the claims for re-processing.

Still, doesn’t that seem like a huge waste of everybody’s time over something so simple?

Here it seems that it’s a good thing that I have health insurance because I’m stressed but I’m stressed because I have health insurance!  Figure that one out!

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12 thoughts on “Having Health Insurance Is Hazardous To My Health!

  1. Gee, you'd think nobody besides you ever had a baby before on that plan, so this is just a one-time problem(!). What a PITA. They must be doing it on purpose, hoping some people don't dispute it.

  2. Actually, the problem is most likely because you're the father. Most babies are automatically added to the mother's insurance due to state laws.
    Your insurance company does not know if your wife has seperate insurance or not, so, in accordance with state laws, they send out these forms.
    If I were you, I'd be thrilled that your insurance company was processing your claims so quickly (even if it was denying them). Its pretty amazing turn around time, if they're processing the claim before you even have time to receive some paperwork in the mail.

  3. I have not had health insurance for years because i know that I can always get it if I really need it

  4. If I were one of the conspiracy theorists, I would say the insurance company is trying to delay payment! By delaying payment they make more money. Denying claims really makes more money.

  5. That seems like such a poor system they have. The crazy thing is, I'm guessing that there was more than just a little thought along the way as to why they handle things in that way. One thing appears clear: those thoughts aren't putting the customers first!

    Healthcare in general (this includes insurance entities)is an industry that has issues with putting customers first – much less truly viewing patients as customers. I've been sharing my thoughts on that a bit recently over at my blog:)

  6. Years ago I worked for a company that processed hospital health care claim forms. It was all about resubmitting the forms and making sure it had the correct CPT and diagnosis codes on them in order for the insurance to approve them. With enough tweaking, insurance companies processed and paid most of the forms by the 2nd or 3rd submittal. Insurance companies like to go around in circles, I guess.

  7. That is really a very poor system and for you to have to go through that can really stressed you out. At least, the lady is nice to admit it instead of trying to blame it on you.

  8. I feel your pain. When I had my baby, HR never let me know I had to add her to my plan. (I thought it was done automatically.) By the time I realized I had to add her (after claims were rejected), it was 2 days beyond the limit my employer put on signing her up.

    I called the insurance company, and they had no limit on the time when she could be added, but my company refused to bend. I ended up having to put my baby on Medicaid coverage until the next open enrollment session!

  9. Despite my many battles with health insurance companies, I was surprised at the whole process required to add newborns and hospital bills I got and had to dispute for "regular" baby-related things like c-sections, hospital stay in the first 30 days etc.. With all the life changes you're going through in the first few months, insurance was the last thing I wanted to deal with. Not to mention dealing with disability paperwork (not complaining because I know that I'm fortunate to even get disability and job protection in the state of CA).

  10. Ironic, isn't it? But in my opinion, it's all about the individual who chooses the health insurance plans. As long as you consider your options carefully, insurance pays in dividends.

  11. It's the same case here in India. People prefer to go without a health insurance on account of the hassles they have to encounter with a health insurance.

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