September 27, 2010

Today was pretty much a normal day, Aj went to see Dr. Koch for a pre transplant dental exam. He needs a deep cleaning they said. But I want to talk to Dr. H and see if that is a good idea. They would clean under the gum around the teeth and I am pretty sure that will make the whole mouth bleed. Not sure that is good for infection risk or if the antibiotics would take care of that.
Dr. K said that it needs doing or he could get an infection later on from build up that he has.

We got the kit for stem cell match last week so Aj brought that in to Dr. H office today (he had to draw blood). Oliver got his last week too. Not sure how long it takes for this to come back, keep your fingers crossed that Oliver is a match. Now, this is only for back up as we are going with the Auto transplant but we hope that Oliver is the match just in case.

Aj is feeling good and looks good. He was back in his office working - the beauty of having your office in your house. :)

I had the joy of working through a huge bunch of EOBs and bills today. Its amazing how much paperwork it takes for one patient. I figured I should sort all them out before they start coming again. It is frustrating to see how the American Health system works. For example, I got a bill from MD Anderson for $750 in August.
It doesn't say what the bill is for, just that we owe them $750.
I call them and ask them when the service was given, to see if I could find the EOB to match the bill. The lady tells me that insurance has not covered any of this bill. I ask her to fax an itimized bill and also ask what it was for. It was for lab work.
She then tells me I need to contact the insurance company and ask them why they didn't pay anything.

I call insurance company up who are happy to tell me that because MD Anderson didn't put the claim in with another one they had for the same day, they won't pay this one. I ask insurance company if it really matters how many pieces of paper they get, its still the same amount. But NO, that is not how they work.
Insurance lady tells me to call MD Anderson back and tell them to send them some medical charts and other info to explain why they had separated the claims.
I asked the insurance lady if they had told them this already, her answer was yes they have sent a letter to them when it first got denied.
Ok, I call MD A back again... tell them that they need to send an explanation back to insurance because the split the claim bla bla bla.. I also asked her if they had received a letter from them when it got denied. She then goes, well maybe it was attached to the claim when it came back!!!!!

Great, they get an explanation to why the claim got denied. Instead of sending the insurance company the info they ask for, they just sent us the bill instead! I guess that was easier than collecting info. Also, that the insurance company would just say - hmmm hospital did wrong... we are not going to pay for it, claim denied. Who has to pay for it then..... PATIENT!

It is just so wrong..... :) bet you they are having this system so that people will be sick, anything from heart attacks from arguing with insurance agents to ulcers from being stressed over bogus bills!