I have always prided myself as an expert in getting through red tape. The past few weeks of changing insurance companies have been daunting, but I managed to miraculously get my expensive and often-denied CVID treatment approved with only a two week gap.
So here is some advice for anyone who is fighting with insurance companies, medical billing, chronic illness coverage, or any other general bulls^&* Americans have to go through in our wretched healthcare
1) Most doctor’s offices do not have email – especially the billing departments. But they do use faxes for everything. And you don’t have a fax machine because it is 2019. Solution: Put together a detailed letter along with all your receipts – notes, charts, everything and more that they could possibly need to help you. Find out their fax number and use FaxZero to send as a fax through your computer for free.
2) No one will ever be able to help you via customer service phone lines anywhere ever. And you will never get direct contact info for a human. Go to the insurance company’s social media on Facebook and Twitter and send a message. With IBX, I got an autoresponse with a general social media email. After that, I got an actual reply from a firstname.lastname@example.org. I even got a phone call from this real-life person. When in doubt, hit social media and stalk out a real person’s email.
3) Nobody knows what they are talking about. Everyone will tell you something different and leave you on a hamster wheel. “Your insurance company is the one you need to speak with. “No, that’s for your prescription benefits company.” “Oh, we aren’t a preferred pharmacy.” “We don’t have you in our records.” “Your doctor never sent that fax.”
Don’t let them. Get every name, phone number, email, confirmation number, and receipt. Oh, yes, being sick is a damn full-time job. Found a helpful person named Melinda. Haunt Melinda’s life. Oh, Melinda doesn’t get in til 2? l will call at 2:01.
4) You don’t give receipts? I will TAKE A PICTURE. My former specialty pharmacy just came to pick up $10,000 worth of rented machines from me and tried to tell my husband he would be emailed a receipt. No, sir, I am not playing. I told my husband to take a picture of the physical exchange of goods.
5) See if your insurance company will hook you up with an advocate. If not, there are nurse advocates, patient advocates, and even certain health insurance brokers who do this kind of work. Also, some pharmaceutical companies have programs set up specifically set up to assist people trying to get insurance coverage for their drugs. In my case, it was My IG Source.
6) If someone is actually helpful – or goes above and beyond – thank them. I mean really thank them. I sent a dozen donuts (LEGIT donuts, not Dunkin) to my doctor’s office staff who said they were just doing their jobs – but, really, these days just doing your job is enough to deserve all the donuts.
I know how many of us are dealing with this kind of insult-to-injury stress. I’m still cracking up about my friend who just had her 5-year-old’s treatment coverage denied because they
Until we get politicians who give