Insurance Idiot

SassFrass · May 2014

The guy I talked to through our insurance is a dipshit. My RE sent paper work with a questionnaire for our insurance with codes and such to see what is covered, what percentage is covered etc, so we can determine our oop expenses, and this friggin idiot didn't have a clue what I was talking about. So he instead he made me give him all the codes, and then was like oh this is going to take awhile I am going to have to call you back with this information.

I feel like an idiot trying to get him to just go question by question with me and making me feel stupid in the process... Idk what is so hard about " is my initial consult fee covered? here is the code... what percent do you cover with this...?" etc same format with each question... GRR!

Vent over!

CeCe8579 · May 2014

Generally insurance customer service reps don't have codes. That would be escalated to a specialist or sometimes even a nurse. My sister and ex-EH both work in health insurance customer service. Therefore, I don't see why it would be his fault.

The RE's office should be able to check that though or you should have that information in your coverage summary.

GraceyandTroy · May 2014

Unfortunately, insurance is very complicated and what you described sounds pretty standard. You better brace yourself for lots of phone calls and conversations re-explaining your situation and asking the same questions over and over.

ConstanceGoodspeed · May 2014

Yes, you will also get different answers depending on who you talk to at your insurance company.

For one charge I kept calling until I got someone who said it was covered and cleared it, which took over a year from the procedure (I knew it was covered but they were giving me a run around).

sailorgal · May 2014

I took a look at our insurance coverage booklet...you should be able to request one if you don't already have it. Turns out none of ours is covered through my hubby's new work but it still listed it.

MrsAtch · May 2014

That's so frustrating. I hate that fertility treatment of any kind seems to be ignored by insurance (certainly here in Maine anyway).

SassFrass · May 2014

Thanks for the input ladies! I was just really frustrated! My RE office sent a form w questions for the insurance company with the billing codes, so I had them available for the rep... I still haven't heard back, but in my booklet it says that 90% of diagnostics is covered until we reach $4,500 in oop, and then after that 100% of diagnostics is covered, but treatment itself will be 100% oop... It just took me awhile to understand I guess.

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