Thursday, March 13, 2008

Sick Again

Jack is sick again. Not sure how he keeps getting sick when no one else in the house is sick and he doesn't go to school. This time I'm pretty sure it's the flu. He was absolutely miserable Tuesday and Wednesday nights and neither one of us has had much sleep. He's requiring oxygen, which he hasn't needed since his surgery in 2006. Last night, as I was looking at his pained faced, the light went on (in my feeble brain) and I remembered that when we saw Jack's pulmonologist last November, he gave me a prescription for Tamiflu just in case we needed it. I quick found the script, gave it to Mark and he was off and running to find a pharmacy that could fill it (took three tries to find one). Jack seems to be feeling better tonight, although he is still on O2. Hopefully, the Tamiflu will shorten the course of whatever is going on.

Earlier this week, I was reading through the stack of EOBs (Explanation of Benefits) we get every week from the insurance company and I noticed that there were all these charges to the facility where Jack had the radiation treatments to his salivary glands. The charges were for dates we weren't even there. The real kicker was a $14,000 charge for the period of 1/8/08 through 2/8/08. The only treatment Jack had in 2008 was the one time radiation treatment on 1/9/08. I called the hospital's billing department and, naturally, the person I spoke with acted like she didn't know anything or couldn't tell me anything. All she wanted to know was whether I had to pay something due to these alleged incorrect billings. I told her "no" I did not have to pay anything, but that was not the issue. Billing for services that were not provided is fraud! She agreed to send me detailed bills so I could see what they are billing us for. I then called the insurance company and asked where I send a letter to dispute the charges. She too couldn't understand what the big deal was since I wasn't having to come out of pocket for any of these charges. Why is it that when the insurance company wrongfully denies payment for something they should pay, the person at the other end of the phone cops an attitude and treats you like you are an idiot, yet, paying for charges that are bogus seems to get no reaction out of them? I did find out that the $14,000 charge was for lab work. Uh, NO! Jack didn't have a single lab drawn in connection with his radiation treatments. I'm really close to going to the Department of Insurance and the media with this because it is flat out fraud on the part of the hospital and wrong that the insurance company doesn't seem to care. I try not to let insurance stuff get to me because it truly is a battle that can't be won, but I'm ready to at least make someone's life uncomfortable over this.

Speaking of idiocy, I was told on Monday that notwithstanding the fact that the company that sells the eye gaze communication system is located within miles of my house, the system would have to be shipped to the company that is an approved DDD vendor (and which is located in another state) and then that company will ship the equipment to us. Expected time of arrival -- several months! This, instead of allowing the company representative to drive down the street to our house and set up the equipment for us. Fast forward to Wednesday and through some magic, the company was able to convince DDD to allow the system to be delivered directly to us. Expected time of arrival -- next week!

Onward we march .................

In this life we can not always do great things.
But we can do small things with great love.

Mother Teresa


julie w said...

Glad you're finally getting the eye gaze system, but sorry to hear that poor Jack is sick again, hope the meds do the trick. We are battling with something here too, I hope it doesn't get worse.
I can't believe those charges, you should go to the media with that - I agree, it's fraud, don't let them get away with it!


Anonymous said...

I'm so sorry that Jack is sick again. Give him lots of hugs and kisses.

I'm not suprised to learn of the moronic attitude and the fraudulent charges. Idiots abound in the healthcare system.

I hope the eye gaze equipment is up and running perfectly next week. I'm so excited for Jack!

Rachel Marini said...

I'm sorry to hear Jack has gotten the flu :( Faith was on Tamiflu as well recently and it really seemed to help her turn around quickly. I know this is the last thing you need.

I don't know how you have withstood all annoying and unnecessary phone calls, disagreements, dilemas, headaches with insurance and equipment companies and doctors. I guess you do what you've gotta do, right?

Praying for a quick recovery for Jack...


Melisande said...

Hope Jack is feeling better soon! I can feel for him. We have had a horrible winter for us around here with sickness! You would think all that beautiful sunshine would kill those bugs! :)

Glad to hear he's getting his eye gaze system. Long story, we still don't have our system, YET and it's been almost a year. Insanity!!

Anonymous said...

Ann -
Sorry to read of jack's sickness. I had to comment on your frustration with the insurance stuff. I've gotten wrong supplies, which were quickly replaced, but the vendor does not seem to care about taking back the wrong deliveries, since they are paid. Annoying to me.

- betty