Monday, November 13, 2006

On Hold

Ugh.

A few months back I posted on trying to get reimbursed for Marty's glasses. Well, guess what.

I'm still trying.

Quick recap: In August I mailed in the claim. In September when I called to follow up on it, there was no record of it. Oh, but I should have submitted it through NC, not MD.

New stuff: I mailed the claim into NC. And when I tried to follow up on it, surprise, surprise, still no record of it. And then I got a denial from the group that covers our vision benefits--it was denied because it's not covered--by our VISION benefits. But it IS covered by our MEDICAL benefits. It seems someone saw that it was for glasses and thought they'd go ahead and forward it. Except they shouldn't have.

And then I made another phone call. I spoke to a nice person name CaramelApple. She said, "Hey, why don't you fax that stuff on to me, and I'll take care of it."

So I faxed it.

I even called to verify that the fax was received. It was.

And then I waited some more before calling again. STILL. NO. RECORD. OF. THIS. CLAIM. This time I talked to Ms. TatorTot. She told me to re-fax it to her. I tried. The fax failed twice. So I called to verify that I had the right fax number. I was given another number, and it failed twice too. So I faxed it ATTN: Ms. TatorTot to the same number CaramelApple had given me because Ms. TatorTot had mentioned that CaramelApple worked just a few aisles away and that she was the only Ms. TatorTot that worked there. Finally the fax worked.

But not exactly right.

But first, I got another DENIAL from the vision benefits group.

I called to check on the status of my last fax, and their record in the computer (which I'm sure is getting lengthy for me) indicated that Ms. TatorTot was still waiting on the fax. So I was given yet another fax number for her. Fax went through.

And this time, for good measure I also faxed it to our case manager, who technically isn't supposed to do this stuff, but I've discovered that she can help make things happen.

And then I called to confirm that Ms. TatorTot had received it.

I sat on hold. I talked to someone who put me on hold. I talked to someone else who put me on hold. Then I talked to SodaPop, who happens to be Ms. TatorTot's supervisor. She gave me Ms. TatorTot's personal fax number (not a number I'd been given) and her own personal fax number. She said she herself would work on it and even apologized for how much trouble this is being.

Tomorrow I plan to call to make sure at least one of today's four faxes got received and is being processed. And hopefully not being forwarded to the vision group.

13 comments:

Boss said...

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

That's all I can think of to say.

Lady said...

Headaches! Wasted Time! Inefficiences!!! Hassles! Headaches!

Crazy Horse Lady said...

UGH.
DOUBLE UGH.

Peanut said...

I called to see if my faxes had been received... I was put on hold. Next I was asked, "Can you tell me what fax number you faxed it to?" !!!!!!

Crazy Horse Lady said...

They better watch out before they catch the wrath of SuperPeanut! I think you have the patience of a saint!

Anonymous said...

your determination will help you go far.

B said...

I'm still dealing with our insurance co. for Buddy's surgery back in JANUARY! (Same type of deal...they sent it to dental not medical when we specifically requested the medical insurance be billed!) I am so fed up at this point! I'm glad that SodaPop seems to be helping you out. A hearty good luck to you!

B said...

I'm still dealing with our insurance co. for Buddy's surgery back in JANUARY! (Same type of deal...they sent it to dental not medical when we specifically requested the medical insurance be billed!) I am so fed up at this point! I'm glad that SodaPop seems to be helping you out. A hearty good luck to you!

Peanut said...

UPDATE: I just checked our account online, and there's a pending claim for the right date and right amount... It's made it into the system! Next hurdle--not get denied...

MMA Lady said...

What is with insurance stuff???? We have a situation with one of Banana's well-child appointments. He got his shots at 6 mos. and saw our regular dr. that the kids ALWAYS see and whom we know personally anyway because she goes to our church. OK, so we know her. We see her all the time when we go to the dr. She was not a pretend doctor wearing a costume of our regular doctor or anything - IT WAS OUR DOCTOR!!!! So we get something from BC/BS saying that the visit / shots were NOT covered because the doctor that we saw was new at the practice and not covered by our insurance!!!! WHAT WHAT WHAT????? So we're taking care of that little ditty. I am sorry for all your frustrations. I hope it is ironed out (and not denied!) by now!!!! Oh, and I like anonymous's comment - it's like a fortune in a fortune cookie!

CAROLIONESS said...

Do we need to call Lars and have him send his people to take care of this?!

CAROLIONESS said...

I had some insurance problems recently too. Really though the problem came from my employer not the insurance company. The ins. comp. actually worked with us while the lady in personnel said, "you have to do it within 30 days after your married or wait until open enrollment in about another month." Dumb, dumb, dumb!!! The insurance allowed us to just fix it. I really don't like the people at my district office right now.

Anonymous said...

Having a separate line for the fax helps because you can demand that the person hold on the line while you fax it to their personal fax machine. But then the worker gets squirmish about the idea of giving you their "personal" fax number at work because you might abuse it and send them crazy faxes for the rest of their working life. I always amazes me how company workers are afraid to give out the company fax number to their desk. Sheesh...(Russ)