Thursday, April 29, 2010

email from company B and another phone call

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?”

Another gem:

“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.


  1. What in the world! Doesn't your hubby get coverage from the FS? Is this the company thats BSing you?

  2. Damn, this is really awful! I did manage to request in writing my blood tests from the hospital (the clinic would give them to you no problem, but hospitals are funny that way) and you could try working with the billing department in your hospital to see if they help you out somehow. Sometimes it's just a matter to get put through to the right person. I'm thinking of you!

  3. No, no, no! They should reimburse you regardless of where you deliver. I've delivered at home at overseas and they've always reimbursed. Talk to the doc at post, and if (s)he isn't helpful, get the email of the nurse at Main MED who handles OB evacuations and ask her about reimbursement. Find some other women at post, or thru livelines, who have been through this - there has to be someone - and find out how they handled it. So frustrating!

  4. oh my god - I was thinking of you and how awful this situation you are going through is the other day when I had to call my insurance company. I hate doing it but they are re-submitting claims and it only took about half an hour.
    I was thinking of you and empathizing about all you have to go through. I detest just having to make a short call but you are subject to the obtuseness of a system that seems determined to fail you. I wish there was someone higher up in the FS you could talk to - but it sounds like you have left no stone unturned.
    I am so sorry you are going through this. Is there any way to switch to company A - or are they just as bad? I know this won't get your bills paid but maybe it would help for future claims?
    Sending strength to fight the bureaucracy and hugs!
    How's the beautiful Guinness doing?

  5. Yes, the coverage is through the FS, but we have to pay for it. We have two options overseas and can't switch to the other company until "open season", late next fall.

    My doctor is in private practice and nothing goes through the hospital billing department, so I'm out of luck with that. The lab has refused written and verbal requests for blood work results. They've told me to contact the doctor. ::head spins::

    Donna, I've been told that a "fund site" will only be opened if I deliver in Ireland. If I go back to the U.S., maternity care received in Ireland will only be covered through Company B. I have dealt with the OB evac coordinator at MED. She told me that she has never heard of this happening before (which I find very hard to believe) and then gave me the phone number for Company B of Georgia. I was livid.

    There is another spouse here who also had trouble with Company B, but she delivered in Ireland, got the "fund site", etc.. Our health unit is VERY aware of the problems I've had with Company B, as is our RMO out of London.
    Bah, so frustrating!!!

    Thanks for asking about darling, baby boy. He's doing well and is currently purring in my lap :)

  6. Oh my goodness C this is a complete nightmare! I sure hope you get some answers and soon. I have no idea how FS works, but would think it should not be this complicated. So gald to read that baby boy is good. xoxo