February 27, 2021 – Insurance and Billing Blunders

I feel like an emotional basket case. Whether it’s due to the full moon or other matters, I cannot be certain. If I could help you understand what I mean by ’emotional basket case’, I would describe it as much like what Humpty-Dumpty experienced before he plummeted to the ground below and shattered into a thousand pieces. Ok, he probably only ‘shattered’ into about 10-20 pieces, but who’s counting? I’ve been fragile and ‘shaky’ all day and susceptible to all kinds of ‘triggers’. A day that held so much promise (apart from the few things I managed to accomplish) turned into a TV day, in other words, what I ‘do’ in order to distract myself from negative thoughts that continually loop in my head. The words ‘defeated’, ‘frustrated’, ‘scared’, ‘angry’, ‘anxious’, and ‘annoyed’ just about sum up all of the emotions I’m dealing with. Why am I feeling this way? Ok, when I mentioned earlier it could possibly be due to the full moon or other matters, I lied. I know exactly why I’m feeling this way. I wish I could say it’s the first time I’ve gone through this, or the last time I will ever have to, but I know better. Yep, it’s the usual suspect, health insurance.

What really sucks is that up until yesterday, I had actually been doing fairly well emotionally. Physically? That’s another story. My blood pressure keeps dropping to such low levels that I feel like a zombie; however, with a good attitude, I can generally persevere. Since I have a really crappy attitude at the moment, it feels like my body’s been dealt a one-two punch (if that even makes any sense). Why the crappy attitude? It all started yesterday, when the phone rang midway through dinner. I didn’t answer it because we were eating but after the ringing stopped, I heard 3 beeps in succession. “They left a message,” I told my husband (between bites of salad), “I’ll check it in a few minutes.” After I finished my meal and cleaned the kitchen, I checked my messages. From the number, I knew it was from the counseling office. Prior to playing the message, I actually was in a great mood. But once I heard it from start to finish, I was pissed! It was the woman from their billing department. She wanted to discuss Medicare and ‘my balance’.

Medicare? “Why on earth is she bringing up Medicare?” I wondered. My counseling sessions are not processed by Medicare; they never have been. It made no sense! Somehow, she got it in her head that because my primary healthcare provider was Medicare and their facility is not Medicare ‘approved’, I am now responsible for paying the entire billed amount (immediately). What?! I cannot, for the life of me, understand why there is now an ‘issue’ when, after submitting multiple, past claims through my (secondary) insurance provider as I’ve indicated (by providing step-by-step instructions), they’ve always been compensated. “Did something change?” I asked myself, “Did the insurance provider modify their coverage so that my counseling sessions are no longer covered?” I had to get to the bottom of it! As much as I wanted to get it resolved, life had other plans. The insurance office was already closed so I had to wait until the morning to try and make heads-or-tails of the situation. When I cannot resolve things, especially when it’s something financially related, it sends me into a tailspin.

As you probably guessed, I didn’t sleep much last night. The more I thought about the message left on my voicemail, the madder I got. From the get-go, it’s been an uphill battle with the counseling office regarding processing my insurance claims. The girl in their billing department keeps getting things confused and then I have to repeatedly call the (secondary) insurance provider to verify that I still have coverage (which I do) and then write down everything the representative said so I can then relay the information (via email) to make certain the billing department processes the claim correctly. When I called the (secondary) insurance provider today, after speaking at length with ‘Barb’ (their representative), I was once again assured that my sessions were covered. “In fact,” Barb noted, “Your claim from January 6 of this year has been approved and applied to your deductible. Also, you’ve already ‘met’ your deductible, so you are only responsible for 25% of all future charges through the end of the fiscal year.” Ha! Take that ‘Billing Department’!!

The problem is, the girl in the billing department is convinced she’s right. I received an email from her earlier today and she stated that after conferring with the ‘owners’, they are now ‘respectfully requesting that I pay my full balance’ as they are not a Medicare ‘approved’ facility. Paying $27 a session is one thing, but paying $108 x 3 (all at once) is another! I don’t know about you, but I don’t have that kind of money ‘floating’ around. What really gets to me is the fact that I don’t actually owe them what they’re asking, if anything at all. They haven’t even submitted the last two claims to insurance for reimbursement. Grrr! As much as I want to pay because I don’t want anything to tarnish my credit, I refuse. I also don’t want to ‘rock the boat’ because I’ve got a good thing going with this therapist. She has been really effective. I feel like I’m between a rock and a hard place but the billing department is clearly wrong and I’m not going to pay money that I don’t actually owe. And I told them so (in a direct, professional way) in an email I sent after I received theirs.

In so many words, I explained that I had spoken at length with a representative from the (secondary) insurance provider in order to get clarification and that once their billing department has submitted all my claims for reimbursement and received compensation, I will gladly pay any balance due at that time. Again, I provided step-by-step instructions so they couldn’t or wouldn’t screw it up, but I’m not holding my breath. I’m a realist and I know better. I just get so tired of dealing with insurance-related matters. I don’t think the ‘patient’ or ‘client’ should have to ‘jump through so many hoops’ and go to such lengths for service. If I had a nickel for every time I’ve had to ‘clarify’ things with insurance on their behalf, I would be a rich woman today. I haven’t heard back from their office, by the way. That’s another thing that leaves me feeling anxious and unsettled. I know myself and I know I’m going to let this B.S. consume me all weekend. Until it’s resolved, I won’t be able to let it go. What is eating me up even more than the money ‘mix up’ is the possibility of having to start ‘anew’ with a different therapist.

It’s exhausting when you have to find a new therapist (that is ‘approved’) and then ‘rehash’ all of your past, not knowing whether that person is even going to be a good fit. And I’ve finally got a good one that is actually helping me. No. She’s not good, she’s exceptional. The fear of losing her and having to go through the maze of possibilities and all of the insurance headaches yet again really struck home. That fear, more than anything, was probably the reason I got triggered and started crying when my husband asked why I changed the password on one of his accounts last night and messed up his ‘system’. It’s also probably the reason why not only my hands shook today, but my entire body did. And after getting out of the house, dropping off my art for the monthly ‘art intake’ at the gallery, running to several stores to purchase all of the best grocery ‘deals’, grabbing dinner, and ultimately heading home, I got triggered (again) and nearly broke down in tears when my husband remarked that I bought the wrong kind of honey.

Yes, my emotions have run the gamut today. I have felt, among other things, ‘defeated’, ‘frustrated’, ‘scared’, ‘angry’, ‘anxious’, and ‘annoyed’. It’s one of the few times that my hubby and I haven’t eaten dinner and then immediately retired to the couch to watch 4 episodes of ‘Community’ back-to-back. Dinner was tense and then afterward, he went to one end of the house and I went to the other, and we gave each other some much-needed space. We are better now but I am still consumed with anxiety. I keep trying to assure myself that even if I did owe the money for the sessions (which I don’t), it wouldn’t ‘break us’. We wouldn’t lose our home or anything drastic like that. It’s just beyond frustrating when I constantly scrimp and save to try and get ahead and then I errantly get a ‘notice’ that I have an outstanding balance (which, in case I need to remind you, I don’t). If you want to see my face go from a nice shade of peach to crimson, tell me I have an outstanding balance. Go ahead. I dare you.

I wish money ‘issues’ didn’t affect me this way but they do. I constantly go online and check my bank account to see whether there have been any deposits or withdrawals and what the current balances are on my credit cards. Each month, I pay them off in their entirety, and I like to get an idea of where I’m at (with overall purchases) from day to day. I, also, pay all of my bills on time (with the exception of the electric bill which has managed to elude me on at least 2-3 occasions). I know it sounds a little neurotic because, let’s face it, it probably is. Anyway, I don’t know what else to share besides the fact that I’ve had a pretty sh*tty day, which I may have mentioned to the cashier at Grocery Outlet when she asked how I was doing. What else was I supposed to say? I would have wound up looking like Pinocchio if I lied by telling her I was ‘good’ or ‘ok’. I don’t need my nose to get any bigger because it would look disproportionate to my face and I don’t need any more body-related issues. I already have plenty as it is.

On that note, I’m going to go to the bathroom and pluck my chin hairs. Just kidding. Why would I do that? I already took care of the bulk of them yesterday! After I check my bank account online one last time, I’ll probably just floss and brush my teeth and then go directly to bed and lay there for at least 2-3 hours while ruminating about everything I just shared with you, my friends! I don’t know about you, but I’m pretty excited about it. If anything, two nights in a row with little sleep should make for an interesting day tomorrow! Yay, cannot wait! Thank you so much for stopping by. For the folks that are ‘following’ me, I am grateful for you and the continued interest you have in reading about the variety of things I talk about each day. I’m no poet laureate or anyone with significant credentials to speak of but I do enjoy the opportunity to share things about my life and family or to just make simple random observations. If all goes well and I haven’t run you off, I trust you will return tomorrow as will I.


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