Tag Archives: Medical Insurance

You talkin’ to me?

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

What do you mean you're not Zsa Zsa?
What do you mean you’re not Zsa Zsa?

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? ”

I win!

We all know I haven’t won…but

“You Just have to Laugh…..”

©2016 Cathy Sikorski

 

 

10 Doubts and Desires for 2015……

HAPPY NEW YEAR  to all my kind and faithful readers!  In the spirit of the New Year, I am taking a Nostradamus point of view and a Pollyanna perspective.

Five things that will not change in 2015:

1. Medical Insurance Companies will not make our lives easier:

I know this is true, because I have already received confusing literature about co-pays, prescription drugs, and durable medical equipment. This from three different places for my brother-in-law, myself, and my friend with the traumatic brain injury. Wading through complicated, confounding medical gobbeldy gook will continue as before.

2. Hospital stays will still make everyone crazy.

Now, granted, no one likes to be in the hospital. But as my brother-in-law just returned home from a bout with the flu (yes, we all had flu shots, to no avail) it still rankles that your own doctor doesn’t come to the hospital any more. You get a ‘hospitalist’ who doesn’t know you, does tests you probably don’t need (because he doesn’t know you) and get a crappy diet because they think you’re a diabetic when you’re not.

3. The skirmish about Obamacare

I am all for everyone having health insurance…..as frustrating as it can be, because I’ve seen first hand what happens when you don’t have it. However, when the new and improved arrives, there will always be problems, glitches and the need to massage it into a better place. And when it is a hot button political issue to boot, well, the conversation will continue to exasperate us all like those year end car sale commercials……endlessly.

4. Dieting

Yep. Here we all are again. Like my Nana used to say, “fat, ragged and sassy.” Will we never cease this battle? Nope.

5.  Facebook.

That’s it. Just Facebook. Persistently annoying and enthralling as it was in 2014 and will continue in 2015.

Five things that will change in 2015:

1. Hotels will give you free WIFI.

Yep. I discovered that in today’s newspaper. Yes, I still have delivered and read an actual newspaper (perhaps that too will end in 2015, but not because I want it to).

2. Airline fares will abate.

C’mon. They just have to. Fuel prices are dropping like flies every day.  The excuses are running cold. Airlines need customers like a fish needs water. Obviously metaphors and similes will dictate cheaper airfares.

3. Customer Service will improve

See #1 and #2. Pundits claim that true business success will return to the customer service model. We can only hope, as customers, that is.

4. People will be kinder and gentler.

I think we are all getting tired of boisterous debate. I declare 2015 the year of the kinder, gentler human being. We saw the film, “Unbroken” on New Year’s Eve. The humiliation of one human being to another is probably the most palpable part of that movie. Perhaps people will stop that, and just be nice, goddamnit.

5. People will stop dieting and laugh more.

We all know that by February 1st most diets will end. And thank God, people don’t seem to laugh so much when they are eating celery and carrots, and nothing else. I predict beer sales and comedy clubs will begin to prosper right around Ballentine’s Day. (yes, I said Ballentine, but for those of you who didn’t grow up on the East Coast, Valentine’s Day is just as good).

I wish you all a happy, hilarious 2015……because……..

You just have to Laugh……..

©Cathy Sikorski 2015