Monday, February 12, 2007

Mother Duckers

Still embroiled in the Ambulance Bill Debacle. You remember the ABD? Yeah, that's the debacle stemming from the Two Penny Incident. The whole question of who's gonna pay for shipping Pearl from one hospital to the next, has become one of those stupid-fest's that make all the business entities involved smell kinda rank.

Nobody is looking good but my ENT, and the ENT's gracious office staff.

First, I spoke with my insurance company who assured me that a letter from my ENT would likely resolve the matter. Since I knew that a letter had been sent, because I had received a copy of said letter... I didn't worry too much. Then the ENT called me and told me that the letter they sent? Had been returned stating that my insurance company didn't know who they were talking about. I told the nice lady at the Doctor's office that I would take it from here, and I would resubmit the letter from the Doctor (I still had the copy they had sent), and write a terse letter to send it on it's merry way to the Appeals Office. I wanted to do this anyway because I felt that the State Insurance Commission needed a heads up, and I planned on cc-ing the whole caboodle to them as per Fantastagirl's and Nobody's advice.

I started to write the letter last week, but when I took a closer look at the bill that Real Cool Ambulance Service had sent me... there in black and white I saw that they had described the service billed for, as "Non-Emergency." I started to laugh!

"Well there ya GO! It's all a big misunderstanding," I thought to myself and proceeded to call the Ambulance folks to explain to them how to get their money from the Schmuckity-ducks.

I explained to the representative who answered that I had discovered the hold-up in them getting their money. They had, for some bizarre reason, mislabeled the service they had rendered to my daughter.

It turns out, there was no misunderstanding. They label any service that does not originate in a 911 call as Non-Emergency, no matter the medical situation. I was informed that was simply how they did it and they didn't plan on changing. Ever. Plus as they are the ONLY company that transfers patients from Provo to SLC... the Schmuckity-Ducks should just know! The End.

When I protested that my insurance company didn't pay for anything that had "non-emergency" appended to it, they pretty much just said that my company, Schmity-Duck Insurance, was the only company who refused to pay based on the language alone, and that currently they (the Ducks) were refusing to pay them (RC Ambulance Co.) for anything. At all.

Here's the part that torques my butt... this is the medical field y'all. It is stupid, but a medical field reality that if the Insurance company won't pay the bill that you have submitted to them? You change the wording on it and resubmit it until they do. There were in fact, three bills in conjunction with the Two Penny Incident that the Schmuckity-Ducks were trying to get out of paying. The companies trying to get their money, apparently each found a way to phrase their services in order to get their dough, because the Ducks did end up paying them. Everyone except the (not so) Real Cool Ambulance Co. Nope. They seem to be more interested in the semantics that their billing software spews, than in getting their crapping money from the Ducks.

I was so pissed I was crying.

The ENT's office manager took my shaky and slightly weepy call, gave me a "there, there honey," and is taking care of my appeal once again. Do they rock? Yes, by cracky, they do!

Your mission, should you choose to accept it, is to tell me what you think I should do for Dr. ENT and his staff by way of saying "Thanks!" All that is coming to mind is the standard "plate o' cookies"... whaddah ya think?


Fantastagirl said...

mmmmm let me think on this one.

Cookies are always good, but sometimes a handwritten thank you goes a long ways. I understand your frustrations, just stay on-top of it.

Mama D said...

That is one crazy story. I really hope it all works out.

If they are YOUR cookies they will be amazing! So yes, a plate of cookies would be fine!

elizasmom said...

Mother Duckers. Heh. I like that and I concur. I hope you get some satisfaction soon. And I concur, cookies for the ENT and staff are lovely, and I would add a thank-you note singling out everyone whose names you can remember who's helped you — it might be a nice thing for them all to have in their files come annual evaluation/raise time...

Lynanne said...

After having worked in a physicians office for many years, I would concur that a plate of treats would be VERY well appreciated :)

the Dread Pirate Rackham said...

very interesting - you know I'm still dealing with the ambulance bill for when I broke my arm. I wonder if the same mother duckers are at it over here?!