This is not looking good. I finally received a response from Company B regarding the insurance fiasco I’ve been dealing with since January. I almost didn’t open the email as there was no indication that it was from Company B or had any affiliation with, and the subject was just bizarre. “*********three letters********” And the three letters were completely random.
Against better judgment, I opened it, fortunately. Yes, I opened it and read such things as
“We have received notification from our Marketing Department that you are requesting assistance in getting overseas claims processed due to the fact that Ireland does not bill medical services or provide the same information that is required for claims submitted in the United States.”
Why it went through the Marketing Department is beyond me, though I probably shouldn’t be surprised. I suppose I should be grateful that they finally grasp that Ireland doesn’t bill for services the way physicians in the U.S. do, but isn’t that the point of paying for “overseas coverage?”
“We do understand that services rendered overseas are handled differently than in the United States; however, ‘Company B’ is required to administer the contract as it is written.”
Contract as written, what???? I don’t care what they claim their contract says. In the paperwork that I have, nowhere does it say that overseas providers must handle billing similarly as is done in the U.S. Again, isn’t that the point of “overseas coverage?” They finally acknowledge that services and payment are handled differently “overseas.” Clearly I’m missing something as to why they won’t pay these claims.
Well, at least they are no longer asking for CPT codes, but it doesn’t change the fact that they are not going to pay for ANYTHING.
This afternoon I was back on the phone with Company B for 45 minutes. After much back and forth, the woman I was speaking to said that they could at least cover the blood work if I could get a breakdown of dates and blood tests from the lab. Are you kidding me? Was she referring to the same lab that won’t even give me a copy of my blood work results? Yeah, good luck getting a breakdown of services and prices.
Just an FYI, I was speaking to another FS spouse earlier this week and she had the same problem with Company B. Fortunately she had a “normal” pregnancy, obstetric care was less expensive, and her doctor worked with the hospital billing department, so after a year of fighting, she was finally reimbursed. She also delivered here so was reimbursed via the “fund site.” It appears that I won’t be so lucky.
And so, here we are, my head still spinning, my claims still unpaid.