Is There A Big Old Bruise on my Forehead?

Because I’ve been beating my head against a brick wall with Blue Cross Blue Sheild.

My bill last December from Radiation Treatments and Brachytherapy was $24,500.  And no, I didn’t mess up the decimal point there.  $24,500. 

I am one of the lucky folks who have employer paid insurance, and I pay extra for the Blue Cross/Blue Sheild insurance because just about every doctor in the US takes BC/BS.  And my benefits are relatively good – I have a $500 per person out of pocket deductible ($1000 for both of us together) and after that, a 90/10 responsibility – insurance pays 90% and I pay 10% – for all covered expenses.  And miraculously, they cover just about everything….just about.  I also have a $3,000 out of pocket ($6,000 for both of us) personal responsibility before insurance kicks in and pays 100% of all covered expenses (too much math too early – I know…I’m sorry).

So, last December, when we I was pushing through daily radiation treatments, and then 3 of the most horrible brachytherapy treatments, I really didn’t think about out of pocket costs.  Cancer treatments quickly eat up that $3,000 out of pocket.  I hit in in August – just after my diagnosis.

Blue Cross decided in March that they didn’t want to pay for my brachytherapy.  Too experimental.  Except its not anymore.  So I got a bill from UMUH for $4,500 – the cost of my three brachytherapy treatments.  What they told me was they needed more information to determine if the treatments were, in fact, necessary.

Because, you know, Cancer is not necessary enough to go through radiation treatments in your hooha.  It was something I decided to do for shits and giggles…you know?  Oh hey, nothing to do this Christmas break…let me go endure having a radioactive rod shoved into my nether regions…you know, because I’m not already sick enough.

So, after months of arguing, and fighting, and fussing, and finally getting my radiation oncologist office to send enough studies to Blue Cross to acknowledge that yes!  Yes this was a necessary treatment!  Hurray!   The treatment was in fact, necessary and yes!  Yes they will pay it!  This was in September.  I didn’t think another thing about it, and went on my merry way.  Until I got another collection call from UMUH.  They only paid for two of the three treatments.  *insert primal scream here*

So I still owe UMUH $957.  I called back at the beginning of October and spoke to “Rob.”  Rob was clearly not at the top of the brain chain.  But, after putting me on hold for 15 minutes (this is 10 months after my radiation treatments ceased) he comes back on the line and says, “Oops.  It appears we *forgot* to pay that charge.”   Rob assured me he’d send it to processing and it would be paid.  Because there was no reason not to pay it – the three treatments were the same.  They paid for two…so why not #3?  Because, well, Oops.  They forgot to.

Uh, what?

Now, this last call with “Rob” was a month ago.  I assumed it would be taken care of, and went back to my business.

Until today.  When I got ANOTHER EFFING Collection call from UMUH.

Insert head banging here.

I called Blue Cross back and spoke to Sam.  Sam sounded as if she had taken a handful of downers before she picked up the call.  She said, “That charge is showing as experimental – we need more information.”

Whatthefuckingfuck?

Sam may feel as if perhaps she should have stayed home today, because she got a royal ass chewing.

I explained to her the situation.  I told her that all three brachytherapy treatments were the same.  ALL. FUCKING. THREE.  So, Sam…can you explain to me why Blue Cross paid for two, and not the third?

It’s under review.

You have to be kidding me.

Seriously.

I’m still looking for the top of my head because it blew off.

When, my dear Sam, did it go down for review? 

October 1st.

Today is the 29th.  Any chance in hell that they are going to make a decision on this soon?

Well they have 30 days.

Seriously. 

I can’t, for the life of me, understand this situation.  But if it isn’t paid by the end of this week, you can rest assured, I’m calling back.  For the 8 bazillionth time.  And Sam and Rob, please don’t answer the phone.  You won’t be happy if you do.

I have called three times over the past two months

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One thought on “Is There A Big Old Bruise on my Forehead?

  1. Insurance companies are definitely a test of patience and strength. Dealing with them is the last thing anyone needs but especially after going thru so much with cancer treatments. I hope this resolves soon for you. Until then be strong and give em hell under they get it right. Good luck!

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