FINALLY!

I work for an insurance company. No....I don't write policies or pay claims....but I am familiar with how the insurance business works. I do get to see both sides of the fence. I get to pay high premiums for little coverage just like everyone else. But I also get to see all the bogus claims that some people file and insurance companies are required to investigate no matter how stupid the claim is. I remember a claim someone filed for products liability. The person claimed that the sun tan lotion she put on her leg did not work and caused 2nd degree burns on her legs. The insurance company had to investigate the claim. It cost the insurance company $10,000 to investigate the claim only to discover that the individual was out in the sun ALL DAY LONG and didn't reapply the lotion. Needless to say the product worked fine and the maker was not liable for damages. This kind of makes you wonder why we pay such high premiums in the first place, huh?

I have been dealing with many people recently regarding my health coverage so we can finally get Lefty taken care of. I am in the 2T and have the ok from the OB to get something done.

Dealing with an insurance person is not fun. It was hard to get them to commit to anything regarding my in-network coverage. I was told we will have to wait until the claim is filed. I can't wait for the claim to be filed because I need to know AHEAD of time how much this could potentially cost. It makes perfect sense to me (and I am sure it made sense to the customer service rep on the phone), but to get a concrete answer is almost impossible.

However, after many phone calls and discussions with the surgeon, my OBGYN, the surgeon's Billing Dept., my insurance carrier, nurses, receptionists, and countless others.......

....it has been determined that any procedure done on Lefty WILL be covered as IN-NETWORK by my insurance! While my surgeon hasn't been officially accepted as in-network yet, the approval should come in a couple of weeks and the surgeon agreed to accept in-network payment from the insurance company if the approval gets delayed. The insurance company was notified by the surgeon of this and then confirmed it with me.

I have a call into the surgeon to schedule something. What that something is I am not sure, but hopefully, SOMETHING will be done sooner than later!

It only took 5 months.....