I’m feeling rather disgusted with our insurance company (CIGNA) lately.
First of all, I’ve been trying to get them to acknowledge a claim (just acknowledge it, not even pay it) for Julian’s home birth since, hmmm, let’s see, probably January 2007. So, what’s that, like 8 months now? Every time I call they say it’s in “pending status” and they need something else – one more code, one more form, one more dotted i. I’ve mailed or faxed them everything they’ve requested and when I called today for my monthly status check, I was told it was still not in the system.
The good news is that the woman (Jennifer) I talked to today seemed honestly interested in helping me get this resolved. Perhaps she was just placating me or perhaps she sensed the utter frustration in my voice and genuinely wanted to help. I guess time will tell.
Sadly, with all of this exposure to insurance crap I’ve been getting over the past several month, I’ve found I’m getting more savvy with their jargon. So today I was able to tell the rep what information has been requested, what I’ve sent in, and where to look on documents for the information she should need, etc. She seemed to think they should have everything they need now and said she would forward it back to the insurance adjuster.
Jennifer is the first person I’ve spoken with there who actually asked for my phone number and said she would call me to let me know how this is resolved (which should take up to 15 business days). I was shocked! I was actually just starting to ask her when I should call back again to get another status report and she said that she would take my number and call me. I’m not going to hold my breath, but I did think that was very nice of her.
I’m still holding out some hope that somehow this claim will be acknowledged and then (*gasp*) approved and they will cut me a check for at least part of the $2200 I paid for my home birth. It’s not that the money wasn’t well-spent (my home birth was worth every penny and then some) or that I would hesitate to do it again, but, plain and simple, we could really use the money. Really.
Since I had this live insurance rep on the phone, after we finished talking about my home birth claim I had another question (one I’ve been trying to get answered for two weeks) about coverage for Ava. I have called the insurance company at least five times over the past two weeks and tried various selections on their phone menu system to try to find out if a speech evaluation would be covered. Unfortunately using the phone system to check eligibility never got me to a live person, no matter how hard I tried. I tried pressing zero, I tried saying “speak to a person” and was met with, “I’m sorry, I didn’t understand your request. Did you mean… (insert everything under the sun except speak with a live human being).” I even tried a few choice swear words which got me nowhere as well (but it helped me feel a little better).
Anyway, I’d been in the process of setting up this speech evaluation for Ava for the past month or so. I had to fill out several forms, fax information in and talk to a “case worker” at the rehab center to get this all arranged. I found out today from Jennifer at CIGNA that speech evaluations for developmental issues are NOT COVERED. In other words, it doesn’t matter if you child has a lisp or can’t say sounds that she should be able to at her age, they won’t cover it. If, however, she has a medical diagnosis, like autism or had been in a car accident and lost her ability to speak, then they would cover it. Is that F’d up or what?!
I got back in touch with the case worker at the rehab center and found out the speech evaluation would cost $441(!) if not picked up by the insurance company, so I canceled it. We will have to go another route. The case worker gave me the number for “Childfind” and said I could schedule a screening with them. I guess that’s our next step. Yay for wasted time! :oP
Maybe tomorrow I will call up CIGNA again and cuss out their automated system, just to help me feel better. 🙂