*sigh* My doctors are in-plan for our PPO, as is the hospital we used. Everything should have had as good a chance as possible of being covered without extra work on our part. Right? Well. Maybe so, but the best case has still had me carefully watching the mail, making numerous phone calls and writing the occasional letter. Basically, there are three problems. One, some claims were submitted before the insurance company got Betsy on their records as existing. Those had to be resubmitted. Two, some of the claims don't have Betsy's name, they just list her as Hoofnagle, BG (baby girl). These have to be resubmitted. And three, the hospital is in plan for us, but not all physicians in the hospital are in plan even if they are the stock doctor on duty for emergencies. In some departments ALL the doctors are contracted as a group and none of them are in-plan. Guess what? The NICU is one of those departments. You never PLAN to land in the neonatal ICU. You have no time to choose a doctor. And they are out-of-network doctors according to Cigna. These claims also have to be submitted. And for each day she's in the ICU there are multiple claims.
Now, the good news is that my ridiculous letter writing campaign will -- with time -- clear this all up. The Cigna people have reassured me this happens all the time and I have grounds to get everything covered. However, I must say this is completely frustrating. I'm relieved that B wasn't in the NICU any longer than 10 days. I'd drop the ball on some bill somewhere and suddenly be on the hook for 50 thousand dollars. It's scary just to see those numbers come in on a This Is Not a Bill statement.
Anyhow, that's what I've just spent most of my morning doing. Just be aware all of you planning-to-procreate folks -- this stuff can and does happen all the time.
Posted by karen at December 11, 2002 12:00 AM