Tag Archives: Times Square

With Facebook Friends like this…Who Needs Enemies?

Two years ago, my Mom called me, practically in tears.

“Roberta was so mean to me,” she said.

I’m thinking, “who the hell is Roberta?”.

“She’s from my medical insurance carrier. I called to ask her why a bill wasn’t paid and she said I should never have been given this insurance and I’m going to have to pay back every penny from the last 15 years.”

“And,” she went on with a worried tone, “you told me to NEVER pay a medical bill. So I don’t know what to do.”

“Calm down, Mom. We will get this worked out. It will be okay.”

My first reaction was this:

I did tell my Mom never to pay a medical bill because her insurance covers everything.

My mom has Tricare For Life Medical Insurance. This insurance is for Veterans and their families, spouses, widows, children. My Dad died in a helicopter crash as an Army pilot on October 10, 1961. My mother had five children all under the age of 10 and was pregnant with her sixth child. So I kind of think my Mom is entitled to this insurance.

The thing is, Mom never claimed this insurance until my step-father passed away in 1998. She didn’t even ask for it. She already had Medicare and AARP. But when she applied for her widow’s the Veteran’s Administration made her jump through all kinds of hoops with documentation and then GAVE her this insurance.

My mom is a Virgo.

Why does that matter? She has kept every single piece of paper that has ever come into her life. So she has every piece of documentation that transpired fifteen years ago with the Veteran’s Administration. The VA put her on the wrong insurance.

So two years ago, they began threatening an 87-year-old widow, who raised her family of six children without a father, a man never even made it to 30 years old, that she would be thousands of dollars in debt to them because of their mistake.

After talking to seven different people at seven different government administrative places which most people never even heard of, we refiled all the documentation from 15 years ago.

I wrote much of this post two years ago.  And much of the problem has been resolved after mountains of paperwork and dozens of phone calls…one that occurred while I was drinking in Times Square. Hey, if they call, you answer, because they may never call back.

I said this two years ago, probably after the drinking incident in Times Square:

 I know from the last 25 years of caregiving and jumping through administrative hoops that this story will not have an easy ending. There’s going to be reams of paperwork. There will likely be boatloads of nastiness. There may be a lawsuit. But in my best, Scarlett O’Hara voice: “As God is my witness….my mother will never pay one dime to fix this problem.”

There’s one small problem that persists. The government agencies just can’t agree and  are trying to collect $687 from my sweet ol’ mom that they think they are owed from overpayments. I still have people in all these agencies working on it and I have not yet caved to paying money to make it go away, but still…..I am amused by the latest missive from one of the insurers trying to collect funds:

Fun things to do while fighting with Insurance
Like us On Facebook……Indeed.

Hmmmm…..I’m struggling with that friend request.

©Cathy Sikorski 2018

 

Medicare….not for the weak……

As I continue down this unrelenting path of caregiving, even in death, I can’t help but see the irony in statements that come my way like, ” what are you doing now that your brother-in-law has died?”

I’ll tell you what I’m doing:

“Hello, Medicare? I’ve now sent you a request for permission to speak to me as Executrix of my brother-in-law’s estate with all the supporting documents. I’ve waited the requisite 50 days for you to process it. I’ve waited longer than that because the first instructions I received were to take those documents to my local Social Security Office, which resulted in absolutely nothing, and now I have finally received a letter saying you will talk to me. Yay.

Medicare Person: What can I help you with?

Me: I’m trying to find out when a claim I have submitted will be paid?

Medicare Person: Why did you submit the claim Ma’am?

Me: Because the provider refused to submit it. They provide drugs and drug paraphernalia to the nursing home where my brother-in-law was residing at the time. They insist that they can only bill for the drugs to Part D Medicare and they have no authority to submit for the other items like IV poles, IV flushes and anything needed to actually administer the drugs.

Medicare Person (the THIRD Medicare person, because the first two couldn’t find the other conversations I’ve had and insisted that no such conversations took place). Yes, I’ve found the conversations you’ve had on April 4th , 11th, and 22nd.

Me: The last person I spoke with who connected me with you said she couldn’t find those conversations.

Medicare Person: Well, you’re both right. She can’t see these conversations, she’s in a different department.

Me: So, she couldn’t transfer me to you without wasting 30 minutes of my time and me insisting I speak to this department?

Medicare Person: I apologize for that Ma’am.

Me being Silent,

Medicare Person: Well, Ma’am I can’t find your claim. it takes 50 days to process.

Me: I filed that claim 120 days ago, and when your Medicare person CALLED ME ON APRIL

Provisions for speaking to Medicare
Provisions for speaking to Medicare

22 while I was standing in the middle of Times Square, and I popped into the closest restaurant and ordered a $12 glass of wine while on hold with your person, she told me that she was looking at my claim, it was paid to the nursing home and they would have to pay the provider. Then she proceeded to send me the wrong Medicare notices so I could prove to the nursing home, they owed the provider and the Estate of my brother-in-law was not liable for this bill.

Medicare Person: I can’t find that claim Ma’am. And so the only thing I can do is request a review.

Me: Okay

Medicare Person: I’m not allowed to request a review until 150 days has passed and it’s only been 120 since you filed the claim. A denial can take up to 150 days to process.

A missing claim is like a missing person. Maybe they went missing on their own. Maybe they are just at a friend’s house and forgot to tell you. Maybe they will use a credit card and then we can trace where they are and stop all this nonsense. But instead of waiting 48 hours, you have to wait 150 days. Imagine telling any person you’ve ever worked with that it will take 150 days to look at a piece of paper you sent them.

Medicare Person and I  then went on to discuss the many fun and esoteric ways that Medicare can screw up a claim.

Medicare Person: I know this is complicated and confusing Ma’am.

Me: I understand perfectly, everything you’ve told me. It’s not complicated or confusing to me, it’s just crazy! (Yep, I really did say that).

Medicare Person: Well, I know it seems complex, but we train for WEEKS to process this, so it would be harder for you to understand.

WEEKS? WEEKS? I’ve been dealing with Medicare for 25 years. And in all your weeks of training, the best you guys have ever given me is ridiculous, arbitrary waiting periods to process claims, a myriad of departments who don’t speak to each other, wrong information that has cost me precious time, and heartburn without the doughnut, wine or deep-fried food I deserve to go with it.

So glad your weeks of training have made you an expert.

I didn’t say any of that, I just got out my corkscrew and toasted the Universe for the never-ending supply of blog posts!

You Just Have to Laugh…………

© Cathy Sikorski 2016