Wednesday, October 19, 2011

16/31 for 21 A thousand tiny drops

Today was not a great day.  Please excuse the venting to follow.  Or just preserve whatever shreds of sanctity and bliss you possess & skip this altogether.  I'm sure tomorrow will be better.  I hope.  How much worse could it be? 

HA-hahahahahaha....

Remember this post, where I proudly announced I had the BEST insurance company in the world?  Alas, it was not to be.  I've been calling providers and gleefully sharing that I had the BEST coverage ever and to please do tell me about your speech therapists so that I may gift you with my patronage and the largess of my major medical coverage.  One was going to check billing since there were in & out of network/geographical issues. They called back and said UHC (that's right, UHC - I'm talking about YOU) wouldn't cover speech absent stroke, trauma, blah, blah, blah....

Now this is what I had initially thought. So in theory we only took a small week-long detour to happy land.  But the rep today (when I called UHC back) was slightly smarmy when she pointed out where on the webpage it listed the endless preconditions and qualifiers (in my defense, it required about 19 click-throughs to get there).  And then I got mad.  Seething, seeing-red furious.  Not only had I called with a specific benefits question, mentioning WHY my daughter needed it, to which I received an easy, Yes! That's covered!,  I then followed up IN WRITING, asking about the geographic issues and hey, by the way, can you confirm I didn't misunderstand, my girl gets 60 visits a year?  Yessirree, 60 visits!

The rep today became much nicer after I said I wanted to lodge a formal complaint.  The supervisor called me later to apologize and said she had "some coaching to do".  No shit.  The words "callously ignorant", "cruel", and "blithely incompetent" were uttered.  The guy that sits near me might have heard me.  I threw in "cruel" just because I had gotten my hopes up.  I knew it was too good to be true but I'd confirmed it twice.  And why not a bit of good luck?  But no.  Whatareyagonnado?

For all my insurance geeks out there, no estoppel argument - even if it ever applies in health care (questionable) - no detrimental reliance.  Meaning at least we haven't racked up 15 newly-uninsured visits.  Unless you count a few ignorantly happy phone calls and my crushed soul, we're not out of pocket. 

On top of that, my girl spent today with her grandparents because she was kicked out of daycare AGAIN.  Her pediatrician sent a note saying she'd been tested & cleared (for the obvious stuff).  Daycare said they wanted a note saying she wasn't contagious - the ped's office asked them to clarify what exactly they wanted ruled out since even I've watched enough House & ER to know you can't test for EVERYTHING.  I mean, can we all agree than testing for malaria and dengue fever is unnecessary?  Is anyone still worried about West Nile or the Swine flu?  The daycare never responded.  And, no, I wasn't quite so sarcastic when I asked. 

Aaannnddd I made the strategic error of cc'ing the school nurse, by way of explanation for yet another absence, and the school nurse sent me back an email intended for the head nurse wherein she suggested even a note from the doctor wasn't enough since "we can't confirm the culture was done".  Really?  Do you think I'm slipping the pediatrician a fiver to draft fraudulent notes?  The nurse didn't respond to my last email either, in which I (nicely!) requested guidance on what they wanted us to test for and since you cc'd me on the other note in error, I'm gathering you want a copy of the lab results too?

My error was that they hadn't really been aware there was a FIVE WEEK long GI issue since it hadn't come, er, up at school, only at daycare.  So now the school is being squeamish too. 

Not that I can really blame them.  I mean, who wants to change that diaper?  But she's clearly not contagious and... am I supposed to take a 6 week leave of absence to handle a non-viral diaper issue?  I'm serious.  I am at a complete loss as to the rules here. 

So there were a dozen phone calls back and forth today about my family issues and not so many about work stuff.  I showed up late this morning and left early to deposit & collect her from her grandparents' house.  Her previously thrice-moved 3 year check up is Friday morning and my son's parent teacher conference is Friday afternoon so I was going to take the day off to attend both.  But we were also going to go visit Gigi in November since my son has fall break anyway, and who thinks they can take a gazillion half days, push the flex time so hard it cracks, and then go on vacation?  No one has said a word to either me or Matt and I technically have loads of time but...  it seems like too much.  Is this just definition Mommy track? 

Aaannndd, adding fuel to the swirling depths (is it me, or does everything sound like a potty joke?) of self-pity, I have a cold (which also reminds me we're probably just going to transition from GI issues to a series of winter colds & fevers).  I'm hoping I might have handled this with a bit more grace & dignity if I didn't feel my head were severed & floating in a sea of cotton balls.  Maybe not. 

I wonder if UHC covers severed body parts.

3 comments:

  1. Crap crap crap! (And yes, I recognize that this is a comment that speaks directly to some of what's going on with you.) I am so sorry! The "you can't come back to school" thing made me sooooo irritable when we were facing it. I started sending her anyway, feeling like they'd have to care enough to call me to come back and get her. And many days they didn't. Perhaps they could tell how out of sorts I was and felt sorry for me.

    Your insurance situation sucks a monkey penis. Lodge a complaint. Make yourself difficult, so that they want to keep you happy.

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  2. Ditto Alison since she expresses it so well :)
    Hugs and better days to you!Figuring out the mommy track thing is a full time job.

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  3. oh man that sucks. I *think* there's something in our state law that means that speech has to be covered, but I'm not exactly sure (quoting hearsay from other parents.) And it doesn't matter anyway cause I can't get an SLP to call me back.

    you are entitled to your vacation! without guilt!

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