Sunday, July 4, 2010

30 minute procedure - 8 claims

For anyone who's pissed about the new health insurance laws, I'd like to talk briefly about my experience filing a claim(s) for what basically amounted to a 30 minute surgical procedure (for Greg).

For this one procedure, including the doctor's office visits beforehand, blood work, etc. there are currently 8 claims on my insurance file. EIGHT. This was a relatively minor procedure, not to minimize any stress that either of us felt going in (especially Greg) but if you have to have surgery this is the kind you want to have - outpatient; checked in at 7, checked out by 11.

So I'm wondering how much time and money was spent simply on the administration of these claims. There was the first doctor's office visit copay, then he got referred to the surgeon, so there was that copay. There was a claim for them to do the blood work pre-surgery, a claim to analyze the blood work, a claim for the actual surgeon's fee, the anesthesiology, the pathology claim for them to look at the lipoma (what Greg had removed, a benign tumor but he needed it removed because it was pressing up against nerves and causing him pain), and then the claim for the surgery center which apparently pays for nurses, equipment and facilities (this was the most expensive claim).

It's like you need a freakin PhD to figure this stuff out. And as frustrated as I am that we have a $3,000.00 deductible (that's what happens when you work for a company that has 18 people) I just calculated that if we didn't have health insurance this 30 minute procedure would've cost us over $13,000.00 which would've literally wiped out our savings. I mean, heaven forbid one of us needed to be in the hospital for something serious or for more than 3 hours and we didn't have insurance, we'd not only lose savings but be put into bankruptcy immediately.

I don't know what's going to happen in 2014. Maybe there will be riots, maybe the whole Health Insurance Reform Act will get reversed if Obama doesn't get a second term, but I seriously hope that doesn't happen. I don't think that protecting people from bankruptcy over something that's for the most part beyond their control (their health) is such a bad thing.

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