Tuesday, January 23, 2007

MY Two Cents Worth

Bleah.

There is a letter that I am struggling with the writing of... I have two solid starts that just peter out about two paragraphs in. The problem is my standard difficulty with self censorship. I have to write to my insurance company to appeal their refusal to pay for the Ambulance ride from Town Hospital to Primary Children's Hospital up in Salt Lake City. They claim that they don't have to pay for ambulance service when it is not an emergency.

There is the difference between the letter that I want to write and the letter that I need to write in order to make those schmuckity-ducks pay. The letter that I WANT to write? Dude, I cannot even post that sucker on this blog, at least not if I want to keep my family friendly status. And I do.

I have given myself a deadline of having it written by Thursday and sent by Friday... they only give you 180 days to appeal, and who knows how many letters this will take.

So here is the blogworthy version of the Letter.... let's see if I can get past paragraph two.


Attention: Schmuckity-ducks at Lame-O Insurance Company,

I recently received a bill from Real Cool Ambulance Co, saying that y'all are refusing to pay them for the services they rendered to our daughter, Pearl Baby Chaos on December 7th, 2006. I couldn't understand why this would be so, as we have the kind of insurance that makes us pay 100% of all medical costs until we, as a family hit our massive freaking deductible. Once the level of "massive freaking deductible" has been reached then Y'ALL are supposed to kick in and pay 100% of everything after that. We have this kind of insurance in case of emergency. This kind of insurance is only good for emergency's and crisis', and we pay our premiums in hopes that we never actually have to prevail upon a Shylock bunch of schmuckity-ducks like YOU to pay our medical bills.

Emergency=scary bad stuff

Well, we hit our deductible and expect y'all to pay for a while. And to your credit, Lame-O Insurance Company is paying for most of it. Just not the two thousand plus for the ambulance because, as your representative on the phone stated... our plan does not pay for ambulance service when used for anything other than an emergency.

The huh?

That ambulance was ordered by our ENT surgeon who was concerned that an emergency tracheotomy would need to be performed on the way to the bigger, cooler hospital. Are y'all good for tracheotomies? Because I'm not, and I would prefer to have the assistance of a trained professional for that kind of maneuver. And there is that word: Emergency, that goes so well with the other word: Tracheotomy. But you couldn't know that from where you sit, so I am telling you now. The doctor is also telling you... see enclosed letter. Also, for your viewing pleasure, the DVD of the Laryngoscopy performed on her just prior to her ambulance ride . What you see in the DVD is a small camera on the end of a rubber tube going down her throat. The big, dark pause in the movie is the doctor having to push hard and wriggle the camera around in order to shove that tiny camera down the tinier amount of space she had left to breath through. Even a schmuckity... I mean, a LAYMAN can see that an unknown SOMETHING was pressing her windpipe shut.

The thing that kills me is that you did not make your decision to refuse payment in a vacuum. You are surely aware that at Primary Children's there was a slew of diagnostics done, as well as surgery and a night spent on the intensive care ward. You payed the crappin' bills, so I HOPE you were aware of this. And yet, this was not an emergency?

Yeah... y'all are pissing me off. Pay. Now.

Thank You
The Mama

9 comments:

Fantastagirl said...

ya know you can also ask the ENT to write a letter stating why it was an emergency, and I would copy your state's insurance commissioner - That usually gets their attention.

Amber said...

I think that letter is perfect. Hilarious and perfect. Stick a stamp on that baby!

(oh, and hi, I've been gone for a while...)

The Absent Minded Housewife said...

Make sure you send all of those things by registered mail. Registered mail is a wonderful thing.

I once had a bill referred to collections that I had paid TWO YEARS prior. Thank the good lord I'd kept the paperwork. I kept sending said proof of payment to the collections agency, via fax, via mail, via stinkin' ESP without results. Finally I sent it registered mail, cc NV's attorney general, with a little note that any further contact from them would be considered harrassment.

They managed to get a clue that time.

Mama D said...

I can't tell you how much I think that sucks. I certainly hope they clue in and cough up the cash!

Funny letter though.

Anonymous said...

FABULOUS letter!!

Anonymous said...

Ohh, good letter. I'm with Amber - I doubledogdare you to send it like it is. And I bet it's a good thing you made that New Year's resolution about the no swearing, huh? Cuase my version would NOT be family-friendly. Lordy, what a bunch of numbskulls.

Anonymous said...

They had BETTER pay under these circumstances. I remember when we had to get Mimi transported from an urgent care center to a hospital -- the emergency room doc insisted that we needed to get an ambulance to do so, in case there were issues. If it's a DOCTOR's decision, they shouldn't have the ability to refuse payment. Geez.

Suburban Gorgon said...

ARGH! A pox on the insurance companies. What the hell is the point of insurance if it only covers the stuff that doesn't cost very much???

the Dread Pirate Rackham said...

oh dear God. I'm screwed. If they didn't pay for a trip because your daughter had pennies in her windpipe, they'll never pay for me and my crazy broken arm trip...