The Demon Insurance..

We rely on health insurance, like most people, to pay for doctors visits, therapy, prescriptions and everything else "Health" related. C's insurance got sold to from Atlas to Chevron with no notice or consent. The previous insurance was great! It covered all of T1's therapies, meds, occupational therapy, behavioral therapy, EVERYTHING as long as we processed everything the way they wanted. Whatever, I'll resubmit a few claims to make you happy.

This new "Insurance" even with the added PAID FOR mental health rider doesn't cover any of T1's current providers "In-Network". At all. Well. That in itself isn't all that big of a deal or surprise. Most reputable places would submit the charges, get them back as "out-of-network" and get them to pay the whatever % and charge us the rest. But No, it gets even better. Morton, one of the ONLY places in town that has a pediatric psych (and the one she's gone to for 2-3 years now and that has gotten her nice and stable) and where she goes to behavioral refuses to. They won't even acknowledge she HAS insurance because "it's too much work and they COULD submit the claims but well, they don't want to." THEY DON'T WANT TO.  So, to continue to go to that facility it's $112 per visit and it won't even go towards the out-of-network deductible - because "they don't want to".


Well. A few things happened with this visit.

1. We saw the pediatric psych. Even for $112, I'm not willing to screw with my kid's meds and to get the meds, we have to see him. Plus there really IS no one else in town I'm willing to take her to. He really IS one of the best in town and we don't have to see him but every several months for a quick check.

2. We may be really screwed when it comes to T1's occupational therapy. I'll probably find that out tomorrow or next week, whenever I talk to the gal over there about it. The good one about that is that lady is more competent that THOSE people at Morton and actually CARE if people get treatment and don't try to dissuade you from being seen. I loved the "Yeah, this visit isn't going to be covered, should I call them and tell them you aren't going?" Umm No, you really shouldn't.. "But, it's gonna cost like $120." So.... It's mood stabilizing drugs for an autistic 7 year old.. I kinda need those. But thanks.

3. My idea of a "detailed receipt" to submit independently and THEIR idea of a "detailed receipt" are NOT the same. I envisioned one with DETAILS. So I can SUBMIT it. So even if They refuse to submit the claims, we can go and submit them for out-of-network credit. There is more than one way to skin a cat, you know.  Apparently, THEIR idea of a "detailed" receipt shows "vscow" (which is oddly the person who took the payments' name) and the dollar amount. Umm.. Not helpful. I need codes, dates, items, etc.. You know the details you use to FILE INSURANCE that you are refusing to do "because you don't want to".

4. We may be in the market for a new behavioral therapist, AGAIN. Or just going once a month until we end up changing insurance again - which will be in 6 months or less. Have I mentioned I am LOVING insurance today?? Which is just killing me. T1 really likes her behavioralist and seems to be making some real progress, but at the same time, is it worth $112 per visit? Because, well. Ehh.. Not as much really. I mean there are some really GREAT things out there but she's just not THAT great. She's worth like.. $25-$30 an hour, but but really over $110 to do stuff I realistically can and DO at home..?

5. Best part ever, this entire thing took 2 hours. 2 hours to be told useless information. Even better? It made us 45 minutes late for another appointment that we had to reschedule. Thankfully, that was done easily, but RRGGG.