So these stories about medical insurance could go on endlessly, but they give me such good material.
My Mom called me a few days ago to tell me that she received eighteen EOBs (Explanation
of Benefits forms) from her medical insurance. If you’re not an EOB counter, 18 is a Zsa Zsa galore. A normal amount might be 2 or 3 on a busy day.
The reason she received 18 is because of the huge mix up created by her medical insurance 15 years ago. Fifteen years is a lot too–a whole teenage year of angst. Now, there are two insurance companies trying to figure out how to pay each other back for 15 years of screwing up.
Half of the EOBs indicate that Insurance Company B paid claims formerly paid by Company A, and everyone is happy about that.
The other half of the envelopes were filled with EOB’s and checks. Lots and lots of checks. All these checks are payable to my Mom for claims going back to 2007. Insurance Company B has paid all that money that is supposed to go to various medical providers to my Mom.
So somehow my 87-year-old Mom is supposed to divvy up these checks, figure out who needs to be paid and how much and hope that the medical providers can properly credit her account, some going back 9 years. Really?
I got on the phone.
I have come to love you so much, my dear readers, that you won’t get every bit of every one of the 4 hour-long conversations I had with Insurance Companies A and B. You know some of this is priceless.
“Hello, my name is John, thank you for calling Insurance Company B, how can I help you?”
“Hi, John, my name is Cathy, I’m calling for my Mom, who is sitting right here with me.”
I hand the phone to my Mom because I know that John needs to interrogate her. She also needs to give John permission to speak to me. After they complete that happy dance, Mom hands the phone back to me.
John asks me for my address.
“No, John, you can’t have my address. You can have my mother’s address, as she is your insured. I have called your insurance company thousands of times and no one has ever asked me for my address.”
“Oh,” said John, “I have to speak to my supervisor.” I’m pretty sure this is John’s first day of work.
He comes back five minutes later and tells me he can’t talk to me if I won’t give him my address. I am undaunted.
I hand the phone to my Mom. He asks for her address, birthdate and phone number. My Mom tells him everything he requests. Then she says,
“Now I want you to talk to my daughter because I have no idea how to deal with any of this.”
She hands me the phone. John and I have a long conversation about how to deal with this complicated problem. John cavalierly tells me that this happens less than one percent of the time. How he knows this from one day on the job, I have no idea. It is, however, supposed to reassure me.
“John, just stop sending checks to my Mom.”
“I have no idea why that happened. They should be going directly to the provider. I have 458 claims here to be processed for your Mom over the last 10 years. But we could just start over. We could reclaim those checks and redo those claims. I don’t know……”
“NOOOOO, John, DO NOT DO THAT!” Yes, I meant to use capital letters, because it was a capital letter kind of response.
“But……,” said John…..”we……”
“No, John, just NO. Do not add insult to injury. Just stop doing what you’re doing.”
“Is there anything else, I can help you with , ma’am?”
“No, John.” I so wanted to say….”But you did talk to me without ever getting my address, didn’t you? ”
We all know I haven’t won…but
“You Just have to Laugh…..”
©2016 Cathy Sikorski