I suspect that my daughter and I are growing too costly and inconvenient for my health plan’s customer profile. They are genius in their tactics to exhaust me financially, emotionally and physically. The company manuals must contain strategies for this, cleverly disguised as “working together.”
It’s mysterious how information I work so hard to obtain seems to vanish into black holes. During my quest for records from a hospital that failed to help my child, I had to revisit the scene of our trauma. Despite being sent to the wrong buildings twice, I persisted and asked another orderly for help. Without breaking stride, she rattled off complicated instructions.
Yet, on top of the network status squabble, my insurance company disagreed with the triage physicians and determined that the hospitalization was “not medically necessary.” Maybe if health plan employees were with members during unspeakable ER experiences, or their company doctors thoroughly examined us, consulted expert colleagues or read our medical histories, there would be fewer catastrophic lapses in judgment. And, before dismissing our prescribed treatments, shouldn’t they at least learn to pronounce our names?
Out-of-network cost-sharing is banned for most emergency and nonemergency services. You can’t be billed for more than the in-network cost-sharing rate.
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