RANT

I don’t know which is worse, health insurance or the billing departments of our hospital/health provider.  

I received a pneumococcal vaccine back in January.  CDC guidelines say people over 50 should get one so my doctor gave me one.  Insurance refused to pay for it saying it didn’t fall within CDC recommendations… 

I have been calling them once a week for all but two weeks since April 24th (when I got the bill for it) trying to get it fixed.  The only reason I stopped was because the insurance told me the incorrect code was used in billing and to let my provider know and have them call them to help them choose the correct code.  I did that thinking it would get taken care of and of course the billing department sent it their coding department, so I waited to hear back.

Two weeks later… today, I get a message saying they are not going to change the code because it was denied by my insurance.  That’s not how it works and if my insurance wants to call them they can.

So, I call my insurance again, and after waiting 20 minutes they tell me my case has been closed.  I explain the whole thing again and tell them they can call the billing and they said, “We don’t call out.” 

UGH!!!!!  They did agree to a three way call but while I was on hold with the billing for over 20 minutes, the insurance got disconnected (hung up?).  So I stayed on the line and talked to billing and they again, refused to help and said insurance can call them….

So… I googled the code that was used and low and behold, it is the code used for 2 month old – 18 year olds… I do not fit in there and surely you can tell that from my chart so I tried calling my doctor to see if it was somehow annotated incorrectly and while I sat on hold refusing to leave a message so I could talk to someone today, it finally forced me to leave a message.

This is all so very frustrating.  This vaccine costs $488!!!  For a recommended vaccine!  

People!  It should NOT be this way!  

Oh, and did I mention that several of the times I called my insurance, I could hear children playing in the background?  One time I could barely hear over the person’s family talking in the background!  They were working from home and not in a private area!   I could hear “Auntie!” in the background.

In case you are wondering the insurance company is Tricare Military and the hospital is St. Luke’s.  Yeah, I’m calling them all out.  Y’ALL Suck.

Okay, rant over.  If you have it in you, pray, send good vibes, whatever good help you can, my way over this.  It’s ridiculous. Absolutely ridiculous.