I believe I've mentioned before that D's new insurance leaves a lot to be desired? No??? Surely you jest... I know I have at some point mentioned it.
Anyways yesterday during a break for the class I was teaching I made the call to the RE's office to schedule a "screening u/s". I was told I had to speak with billing before doing so... great just great. I apparently had to pay x dollars before I could schedule an appt... x dollars about sent me through the roof... see I'm fine with paying 20% I'm even fine with paying our deductible which is 250... I'm not fine with paying x dollars as it's more than 20% and it's definitely above and beyond my deductible... I about started crying. (Those that know me in real life know that tears mean war)
A frantic phone call to D - while still on break as I didn't have my credit card and couldn't run to get it while teaching the class and of course the class wouldn't be done until late in the day so the office would be closed when I finally could get to my credit card - led to D having his jaw hit the steering wheel while at work and for him to also start cursing. It was nice to have someone else be as irritated as I was.
Now my loving husband has never really had to deal with insurance issues... This was a first for him. He needed to talk to the insurance person at work and find out EXACTLY what percent was covered... and also to find out from the RE's office exactly what the freaky people at the 3rd party payor paid and covered etc etc. Can I just say that the 3rd party sucks. Seriously... they suck.
Last week I had to have D fax a check that we had paid the RE's with so that they could refund us 80% of the check... I have yet to receive the check. I had D fax bills that the RE's office sent to them that they have yet to pay. Seriously - what kind of business are they running. I am thoroughly irritated, frustrated etc. I want to choke the chick at the 3rd party that I talked to the other day and who I will be probably be talking to on Monday. Give me an f'ing break - DO YOUR JOB! Don't make me do your job... because believe me I can get uglier.
So... then I found out that the x amount I told D had jumped up as the RE's office had just finished opening the mail when D called and x had turned into xx. We were allowed to pay x, and xx - x has to be paid by Nov 2. D scheduled my u/s... I started hyperventilating. Thank goodness my class was over and on the way home I thought... I know we can pay this... that's not the point. The point is we SHOULD NOT HAVE TO.
D apparently talked to the insurance HR person at his work and she said... you should have seen what I had to do when I was going through cancer treatments... D's jaw dropped and said "Then why the hell does this company keep this 3rd party system?" Because the place he works at is great for some things, but not so great in this area... they are afraid of change. They were told that this whole 3rd party system meant that the insurance while good was cheaper than if they did it another way. D's former employer had similar insurance but without the 3rd party... and if they could do that and stay afloat then I don't see how the heck his current employer who gets the insurance from the same place as the old employer can even think this is reasonable. D says it's because they're lazy - they don't want to go through the effort to find a new insurance... I told D - I'll do the research for them if that's the case... ask them who do I call for them. I'll do it for FREE... just so I don't have to deal with this 3rd party crap ever again.
I know I could find them a deal - probably with the same league that they're using now... but I doubt that D will a) offer me up and b) even if he did that they'd take him up on the offer...
So for now... I am torn - do I pay xx and go on with this cycle (I assume af will be here on Monday which is when that u/s is scheduled) or do I say screw that and cancel the appt take this month off of meds and just do PIO after ovulation... but wait here's the deal. I've met my deductible so now that whole 3rd party... doesn't count anymore - it just goes straight from the insurance company to my RE's office rather than through the whole other system... and Dec 1 is looming when the RE's office will no longer participate with my insurance. Decisions decisions... I have tonight to make my decision. D is of the "we'll do whatever you want to do" position.
*I just want to add I'm all about affordable healthcare... I am not all about this 3rd party system that means our EOB's go to the 3rd party and then they eventually pay them. The EOB's they never come to me... unless I call and ask for them. I've had to circumvent the system and go online - sign up for the EOB's online - download them then unsign up for the EOB's... our insurance company thinks our address and phone number is the 3rd party rather than our own address. *