Insurance woes...

I've been dealing with some insurance nonsense for a couple of months.  I think it is a running joke in the world of breast cancer (and frankly all serious injuries or illnesses) that insurance and billing issues are just par for the course.  It genuinely blows my mind however at how insidious this problem really is.  Generally speaking, I think my treatments, appointments and tests have all been standard of care.  I haven't had anything truly out of the ordinary.  Yet, somehow, my doctors office, medical group and insurance company can't seem to figure it out.

The current issue that I am dealing with truly amazes me.  After each chemotherapy treatment I was given one to three shots to boost my white blood cell count.  I had to go into the doctors office for each of these treatments.  My medical group approved these treatments, and authorized my doctors office to treat.  For some reason they are billing these shots as "self-injectable".  So what difference does that make to me?  Well if it is a straightforward "injectable" (i.e. the doctor gives you a shot, like I experienced) it is covered 100% by insurance.  If however it is a "self-injectable" I have a 30% copay.

I've notified my doctors office of this clear mistake (which by the way I had my insurance company confirm for me) and yet they and my medical group are continuing to argue that it was billed correctly.  This in spite of the fact that my insurance has been denying half of the claims, and payment is delayed as a result.

So tomorrow I will spend another day on the phone trying to get this business sorted out.  Gratefully I know how to read my insurance policy and reasonably understand what I'm reading.  I also have the ability, energy and wherewithal to pay attention and speak up when something is wrong.  I can't help but think about how many people just can't or don't deal with these issues.  I'm willing to bet at least half (if not more) of patients with serious illnesses just accept what is put in front of them and never think to question it.  Makes me want to create a service to help people with this exact issue.  I know I would appreciate someone else keeping track and advocating on my behalf so that I can spend my energy healing, getting healthy and loving my family with whatever is leftover.