Saturday, September 15, 2018

I Can't Guarantee That It Don't Stink, But Apparently It's Made Of Gold

Nothing gets Mrs. Hillbilly Mom's blood boiling like a good throwdown with her insurance company.

Let the record show that I got a denial on my POOP TEST! Which carries a bill of $649. Who knew my poop was so valuable? Maybe I should have insured the return package.

My own representative, who handles insurance disputes for all school employee clients, had made two attempts at remedying the problem, and advised me to file a written appeal. I guess that has to be done by the actual claimant. Also, if it was a lose-lose situation, I'm sure she would have told me I was stuck paying the full amount. My original plan was that if she couldn't fix it, I'd call the Poop Company, and see if I could negotiate a smaller amount if I paid it right then. That can happen, you know.

Anyhoo...the bill from the Poop Company had a phone number, and a paragraph that they encourage anybody who has to pay any amount out of pocket to contact their customer service department for advice on filing an appeal with the health insurance. So I did! I also checked out their website beforehand.

I'd told Farmer H about reading that paragraph about appeal advice on the Poop Company's website. Farmer H knows his way around the inside of company policy. "Obviously, they know they have a problem. So be sure you call them and see what they advise. They wouldn't just put that out there randomly."

So I did. Their number works 7 days a week, 24 hours a day. Now THAT is customer service! Anyhoo...the PoopCoRep was very polite and helpful, advising me on what tactics the insurance rep would try, and how to refute them. He was forearming me by forewarning me. He also assured me not to worry about that $649, because the payment date would be suspended during the appeal. And that I might be able to get the claim re-filed, and not even need an appeal. But if I DID, he directed me to the FORM ON THEIR WEBSITE that is a template for appeals, which would generate an automatic appeal letter to my insurance! Man, was Farmer H ever right! This must be a wide-ranging problem between the Poop Company and the insurance providers.

PoopCoRep really had me loaded for bear! I thanked him for his help, and read back my plan according to his advice. Then he said, "They probably won't be answering the phone this late." Oh, I knew that. I only called him at 9:40 p.m. because I'm so nocturnal. I wanted to ruminate on my plan overnight, review it while driving around on my errands, and call the insurance the following afternoon.

SWEET GUMMI MARY!

It went just as PoopCoRep anticipated! It wasn't his first poop rodeo, by any means.

The other half of the story continues tomorrow...

4 comments:

Anonymous said...

I have no (or very little) doubt that you will win this on appeal!!

River said...

What? You have to pay? (if you don't know your way around it)
Did you request this poop test or does your government just send it out to everyone over a certain age?
We get one sent out every couple of years, (maybe it's three or five years) to everyone over 50, up to age 74 and it's free! It even comes with a return envelope so we don't pay postage.

Hillbilly Mom said...

fishducky,
I like your confidence!

***
River,
The doctor ordered it as a screening test. I'd never had one, and I assumed the insurance would cover most of the cost, as with any other test that his office referred me for. Apparently, the insurance thought differently.

River said...

Ours is a government initiative sent out in hopes of decreasing deaths from bowel cancer. everyone over 50 gets the free test sent out, we return it in the postage paid return envelope and get a letter with the results a couple of weeks later. All free. Well, paid for by the taxes of thousands of workers, just like our Medicare.