Thursday, May 5, 2011

"Insurance Companies are Evil !" -by Heidi

A colleague of mine who worked in the charging/billing department of my hospital used to always say that. She had worked on the insurance side for three or so years and switched to the hospital side when she got fed up. She taught me that insurance companies consider their stockholders their customers, NOT the patients. Patients are PPUs (profit producing units). I didn't believe it at first but, now I definitely believe that insurance companies are not on my side. They are pleasant, but have their own agenda.

When I got cancer I thought: I am intelligent, English is my first language, I have 30 years experience in the health care field.... the financial part will not be hard. But it has been the MOST time consuming and frustrating part of our medical experiences. We are very fortunate that we can pay our bills, thanks to generous family support; and so far, I have not actually yelled at anyone. I don't know how people who are going through their cancer experience by themselves, dealing with their fears and side effects, do it. Get support, yell for support, seek support. You do NOT need to do it alone.

From making sure everyone has the correct insurance info, to assuring that the provider is billing for what actually happened, to navigating through the inevitable denials and appeals processes.. it all takes time and a clear brain and lots of patience and follow through.

And then there are the non-medical costs: lost work days, costs for you and your significant other to park, eat, & purchase items that make your life easier but are not directly reimbursable (over the counter meds, dressings) the list goes on and on. We have some friends who are down from Alaska for his intensive treatment. They had to find an apartment, their kids moved to attend a school down here, he couldn't work; they are amazing in their flexibility and attitude, but finances have been a huge issue.

Things I have learned painfully that might be helpful to you.
  • When talking to a provider's financial people or insurance people, write down name of person you talked to, date, time and content of discussion. Get their direct phone number. Make sure they know that they can leave info on your voice mail.
  • Ask them "what exactly do I need to do to get this fixed" and then read back to them what you heard them say and have them say that that is exactly what they said.
  • Try to match the info from your insurance company EOB with the provider's info (and your memory/notes)
  • Take a deep breath, let the stress go, take another deep breath.
  • Ask your cancer center for any avenues/organizations helping with costs or winding your way through the mazes. Ask your friends, ask online patient forums. We have gotten help with some of the big drug costs for me and that has helped us a lot.
I know others have helpful hints as well. Please feel free to share them.

As always, even in this area of our lives, we are so grateful for YOUR support, prayers and love. We couldn't do it without you.
- Heidi

2 comments:

  1. Good advice Heidi for difficult circumstances.

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  2. Great advice Heidi. The whole administrative process is a nightmare for sure, especially on the insurance side. I have been fortunate that I have not had toooo many hiccups, thanks be to God.

    I feel for you. It shouldn't be this hard, it's a shame.

    Denise

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