Friday, November 6, 2009

I should note it is almost fixed now...

Today was a drag. Okay, it was really this morning (the rest of the day was restful)

I am sick with bronchitis. On Antibiotic for 4 days now. and not really better.

Medium and Small both have bronchitis. and small has an ear infection too.

After much turmoil, which you may read about in a moment... they are both finally on antibiotic too.

We are sadly missing the Lou Engle conference at GHOP this weekend.

now... on with my madness...

It began three weeks ago...

I got an "Adverse Action" letter from Medicaid telling me that they were going to cancel the kids insurance due to "requested verification was not provided".

Ugh... called the caseworker, let's call her "M" now. She called me back the next day and as we talked about it; she says everything is weeks behind and she is sure she has it, if I will simply send her another copy of payroll stubs tomorrow, she will actually cancel this "Adverse Action" notice while we speak. Perfect. That was simple. Thank you. She did that while we were speaking.

No, Not simple.

She did type something and I thanked her.

It just was not simple like I thought.

A week flies by... I get a new "Adverse Action" letter stating we will be cancelled on 10-30 for the same reason.

I call "M" the next day and leave a message. No call back, I call again and leave another message. Later I call again and her mailbox is full, oh she is out of the office. okay. I keep calling and leaving messages.

On 10-30 I call again, only to not reach her. At this point, I think well, I will leave a message with the front desk, again. I do so.

Now, as we all know, I was coming down with bronchitis on 10-30. The boys caught it a few days later, as I still tried to reach "M" and resolve this.

I lost my voice on 11-1.

I go to the doctor with the boys on 11-5. I left another message on my way, as it occurred to me that we might have a problem when we got there.

Sure enough, we did. Now I knew we had coverage and the Dr. office was fine with that. period.

But the pharmacy, not so much.

So after waiting in line for 40 minutes for a 10 minute prescription to be filled, I was not pleased when they told me cash price would be $108 because the boys had no insurance.

I drove home without the prescriptions. Sad and sick and toting sick boys. ugh.

I went home and finally got ahold of "M". She was most upset, she remembered fixing the problem WHILE WE WERE ON THE PHONE BEFORE, and did not know why it was not still fixed. huh. She checked, and then reinstated it immediately, back dating it to 11-1.

Well, after much ado and many, many phone calls... here is the dealio.

"M" reinstated us as of 11-1 but Medicaid listed us as not covered DUE TO NONPAYMENT.

After figuring out WHY it was showing up as No Coverage. (that took many phone calls to other people)

I immediately called the premium payment department. Who promptly informed me that
Medicaid cancelled on 10-30 (for whatever reason) and when they did, they immediately pro-rated and "refunded" our $100 monthly premium. (Still not sure when that refund comes)

Now, I have to resubmit a new payment (which was not actually due yet)... AND wait 5-7 days for it to post as paid ... AND THEN Call THEM to have them backdate the coverage ...

And THEN I can be re-imbursed by the pharmacy for paying full price for the prescription Today.

But all that took 2 days to work out.

Never in my life, prayerfully, never again in my life.

Why is it that these kinds of 47 phone call insurance "incidents" only occur when I am very ill and have absolutely no phone voice and cannot stop crying because I am so sick and just want to crawl into bed and get well??

Well, I say Never again.

The people at the pharmacy were very nice.

"M" the caseworker for our insurance was very nice. and apologetic.

The people at Medicaid were nice. The people at Healthnet were nice. The people at the premium payment center (who do not accept payments except check by mail) were nice.

Just none of them happened to know what was happening, nor how to fix it.

While I struggled for the very voice to talk to each of them 700 different times to find out. and be nice about it.

and that is my story. and I am done with it.

and very very grateful to have 2 boys begin their antibiotic.

Peace that surpasses understanding. and 2 boys that will now begin feeling better! Our life is good. complicated in moments, but good!


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