It's pretty well known that I have a real hatred for insurance companies. This hatred goes back to before I got fired/quit my job and went back to school but it has definitely gotten worse. I'm sure I'm not the only one who hates insurance companies.
Yesterday I came home form school and found 6 EOB's waiting for me. All of them were for treatment/doctor's visits from 11/07 or 12/07. It's nice to know the insurance company got right on my claims. As you may know I had a boob problem in late '06 and another one in late '07. I'm really lucky I don't have three boobs or I'm sure I'd have another boob problem in late '08. I opened up the EOB's and every single one said the insurance company would not be paying the claims because of a pre-existing condition. WHAT?!?!?!?
I very calmly called and asked what the deal was. (I swear I really was calm.) The woman one the phone explained that in '06 when I had the problem with my left boob they also found a few small, BENIGN cysts in my right boob. Because I had previous cysts in my right boob that made my recent claims deniable due to a pre-existing condition. The insurance company would not pay for any service to my boobs until the one year pre-existing wait period was up. (I switched insurance companies in October '07.)
Now I suppose I should have realized all of this but I didn't. Naive I know. I then asked, "Well what if I had breast cancer now?" The lady explained that since I had symptoms or pre-cursors to breast cancer they would not pay any claims related to breast cancer until the one year period was up. To me this means... do not go back to the doctor about your boobs until after October of 08. I asked her to explain it one more time and she she explained that since I had symptoms and treatment in '06 I would not receive any benefits for anything regarding either boob until after October of '08 and that also they wouldn't pay for anything to do with my boobs unless it was also DIAGNOSED after October of '08. I simply hung up pretty distraught because the bill for this round of boob work is going to be very expensive. (I just had another mammogram and sonogram two weeks ago just to make sure everything looked ok right now.)
I went to yoga thinking that would help calm me down. And it did. When I got home I decided to look at the EOB's again just to try and figure out what my bill might be. I realized that one of the EOB's was for a pap smear. I had just assumed they were all for my boob by looking at the dates. I realized they had denied my claim for a pap smear for a pre-existing condition. It was too late to call last night so I called the insurance company this morning.
"May I please speak to Debbie?"
"May I ask whose calling?"
"Lola, I need to speak to her about a claim that was denied."
"Please hold."
I held for twenty minutes. I'm not kidding. I timed it.
"May I help you?"
"Hi Debbie this is Lola. I spoke to you yesterday about a denied claim. I was looking through my EOB's and I just realized you denied a different claim to pay for my pap smear. Could you explain this to me? My benefits say that you pay for pap smears."
"We do."
"Then could you please explain to me why my claim was denied?"
"You'll need to hold on while I pull your file."
Waiting for a long time...
"We denied it for a pre-existing condition."
"Yes Debbie I see that here on the EOB. That's why I'm calling. I do not have a pre-existing condition IN MY VAGINA."
:Big Sigh: "Ma'am I'm just telling you what the records say."
"Debbie I have had this vagina for several years now and I think I'd be aware of a pre-existing condition. I'm pretty on top of things that have to do with that area. I DO NOT HAVE A PRE-EXISTING CONDITION IN MY VAGINA!"
"Ma'am perhaps you should call your doctor."
I hate the fuckers.