Baldies' Blog began originally in the UK by a 26 year old journalist with a blood cancer on a mission to inform the world about bone marrow donation.

He has since died, and I took on the cause of making cancer care more transparent for everybody.

Cancer is a disease that will touch everybody through diagnosis or affiliation: 1 in 2 men will be diagnosed and 1 in 3 woman will hear those words, "You Have Cancer."

I invite you to read how I feel along my journey and
how I am continuing to live a full life alongside my Hodgkin's lymphoma, with me controlling my cancer, not my cancer controlling me.

I hope that "Baldies' Blog" will prepare you to handle whatever life sends you, but especially if it's the message, "You Have Cancer."

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Wednesday, September 10, 2008

I received another bill in the mail that has been fully rejected by my insurance company. Brigham and Woman's has sent me a bill for a dental evaluation. The “evaluation” was actually a review by their dentist of paperwork my local dentist and my dental hygienist (aka mom) had filled out for pretransplant testing.

Unresolved dental carries can spread bacteria into the body leading to such diseases as pericarditis in immunocompromised patients. Impacted wisdom teeth can also become infected leading to septicemia and ultimately death.

This was a bill Jon insisted on dealing with himself. I have long ago given up on dealing with insurance companies. I do not have the energy to wait on hold for an hour, only to be told I do not have the appropriate information, such as codes or what the hospital submitted as a diagnosis (hodgkin’s is rejected but nodular sclerosing is accepted). I no longer even open my bills. I get to angry at the system and frustrated at the situation.

Jon pays monthly for our insurance coverage. We also have a $4000 deductable. I lost my job due to disability. Our family has taken a pay cut, but our medical expenses have increased. We also now have to pay for gas to the hospital and co-pays. We do all this, but we still have no guarantee for the coverage we pay for.

This is why Aunt B is assigned to my medical bills. She has twenty-five years of experience fighting with insurance companies to remit payment to hospitals. She is a professional. I think she is the best. But Jon just had to deal with this bill himself.

The billing department at B&W called when I was trying to nap. I informed them that I was the patient, and I did not deal with my health care bills. My husband would be out of work at 3:30 pm. The woman informed me she would only be working until three, but to tell my husband the bill for my dental evaluation was rejected in full by my health insurance.

“I have dental insurance.” I informed the voice, who had not given her name. “Why would my health insurance cover a dental evaluation. It needs to be resubmitted.” It sounded like common sense to me.

“We don’t do that.” The cold bitch on the other line informed me. “You consented to be charged by submitting the paperwork.”

Excuse me! My mother is a dental health professional! I had never paid for dental care in my life. I had many qualified dentists who would have done the evaluation for free.

“Do you often call sick transplant patients and refuse to fight for coverage?” I shot at her. She responded she was just returning a phone call. I asked her how she slept at night b/c I'm not sure I could live with myself if I was her. I would probably be dead by now.

It was like verbal diarrhea. I wanted to reach through the phone and pimp slap her.

“I was just returning a phone call.” Was her retord. I heard her click and hang up.

I emailed Aunt Barbara about the situation and confessed my verbal assault on a billing clerk. She, of course, promised to look into it. I’m so lucky to have her. She informed me that generally in these situations B&W would send the bill to Dana Farber and the transplant billing clerk would roll the cost into a bill for pretransplant testing. It would then be reimbursed by my health insurance, and Dana Farber would pay Brigham and Women’s.

Hopefully, someday, I will make enough of an impression to stop these occurrences. Until then, I have Aunt B on the case.

1 comment:

Anonymous said...

It is so worth hearing these stories. It is how the insurance companies win,,,,the wear us out. It is wonderful that you have someone to help. BTW you HAVE MADE A HUGE DIFFERENCE to more people than you will ever know or need to Know. thanks for the privilege.