tanpopo craft

grrr...

my medical insurance, actually my husband's company one sucks....empire blue cross/blue shield of new york.
since we got the insurance, i've had to call 90% of the time to make sure all my claims are taken care of properly. sometimes (never mind, it's a lot of the time, ARGHHH!), there are huge discrepancies in the claims, which i have to correct and clarify.

the reason this time is that my son was taking about 6 months of synagis injections for RSV and it was approved by the medical management team about october 26, 2004. i have even the form letter stating the fact. then, three months later i receive one of those claim report things that they send every instance a service is charged to the insurance...this time it's for a synagis shot my son received in march....now the insurance company penalized us about 1000.00 more or less for not informing medical management about his synagis shot. i had to call and repeal this claim (among others that i had to fix on the phone EST), telling them that his synagis was approved months ago and that i had a letter stating that it was medically necessary. the member rep had to repeal the claim with the confirmation number of the approval letter to get rid of the penalty.

although i am happy i don't have to pay for the damn thing, i dread the next appointment. calling practically every time to get stuff done right is truly annoying. ...it sucks major ass!!