Friday, March 20, 2015

Lactategate 3



I was hoping a third chapter to this saga would prove unnecessary. I was wrong. After having been told that the mailroom had been instructed to simply return my check for $15.59, I waited patiently for the fiasco to end. It was not to be. After a little more than a week, the check of destiny had not yet graced my mailbox. I yet again dialed the number for my provider and inquired as to the status. I was placed on several brief holds while the associate “got me some answers.” When he came back on the line, here is what happened:

Them – Sir, we are unable to locate the check that you sent us.
Me – What do you mean? Are you saying that you never received the check or that you received the check and it has been misplaced?
Them – It appears that the postal service lost it. Don’t worry though, I have placed a request for the check to be canceled and a new check issued. As soon as that is completed, we will get the new check out to you.
Me – Do you know when that will be?
Them – We can ask that you be notified when it occurs but I have no way of knowing when that will happen.
Me – So let me get this straight. Your new plan is to issue a new check at some indeterminate point in the future and turn over possession of that check to the same courier agency that you accuse of being inept enough to lost the original check?
Them - (slight pause) Yes…
Me – Well this can’t miss.
Them – I understand that you are frustrated and we appreciate your patience. It will just take some time. You will get a call very soon once the check is cut.  
I then decided to go for broke and ask about an interesting item listed under my specific plan in a section labeled “My Benefits.” Under In-Network Inpatient Services there was a line that denoted that a Maternity Delivery (Inpatient Physician Services) would not be subject to the traditional $250 co-pay for a hospital admittance. This was curious since my wife had experienced an inpatient maternity delivery at an in-network hospital.

The parenthetical “Inpatient Physician Services” line was somewhat perplexing since our plan does not require a co-pay on any physician services. Furthermore, is it even possible to have an Inpatient Maternity Delivery at an In-Network Hospital performed by an outpatient physician?
This line of questioning led me only further down the rabbit hole:

Them – Sir, that benefit would only waive the co-pay on the physician’s fee for an in-network maternity delivery. It does not waive the co-pay on the facility in which the physician delivers the child.
 Me – But the parameters of this plan do not allow for any situation where I would ever owe a co-pay to a physician.
Them – I see what you are saying, but this benefit does not apply to you.
Me – But when I login under my exact credentials, it appears under the header “My Benefits.” That means that you guys are specifically touting a hypothetical exemption from a fee that doesn’t actually exist and listing it as a benefit.
Them – I am not sure why you are seeing that but…
Me – If you guys are going that direction I really feel like you could go all the way and market that you will waive all fees associated with Leprechaun heart-cath. The entire In-patient benefit matrix is needlessly complicated. In fact, any situation involving an inpatient facility (whether it be in or out of network) costs the exact same. So instead of 8 lines of mythical co-pay exemption you could simply have one line that says You Go To Hospital = You Pay $250 Co-pay.
Them – That is certainly something to take under advisement. Is there anything else I can for you today?

I have since made yet another call to them since I did not hear back that the new check had been cut. I was told that it could take up to 14 business days to cut the check, at which point an as-yet-unnamed employee in an as-yet-to be determined department will call to alert me. They will presumably then hand this check to the United States Postal Service. All I can say is that if I open the envelope and there is a duplicate check for the $10.40 I already have; there is an elevated probability that my insurance provider will be the recipient of a Medela Molotov Cocktail.


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