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Insurance woes

January 3rd, 2008 at 08:36 pm

I've done well financially so far this year (I know, it's only been three days)! The only money I've spent is $.50 each day for the newspaper. (I don't make this a habit, but with football playoffs coming, you can't beat the NY Post). I've eaten breakfast at home and brought lunch to work so no money spent there.

DS's speech therapist is here this afternoon. We finally won the battle with the insurance company to reimburse us for our costs. Unfortunately, she charges $100 per session, of which $84 is "reasonable and customary". I have a $20 deductible per visit, so they give me back $64 per session. Not bad, considering I thought I'd get nothing for a long while.

I need to resume my battle with them, however. The therapist is out of network, but they gave me an exception to treat her as in-network because nobody else was available in our area. The exception ran out on December 13th, but we still need her. We're trying to get them to extend the date, and they're balking big time. I guess they need to make it difficult to keep them afloat financially, but man is it frustrating! So I'll call and see if I can make any headway with them.

Hubby's uncle passed away, so we need to go to the wake tonight and funeral tomorrow. We'll have to pay the babysitter tonight, and we bought flowers for the wake. (I'd prefer a charitable donation in his memory, but I lost out).

We've also got friends coming over tomorrow and Saturday for dinner, so I'll need to go shopping for that. This year, I'm categorizing that as "entertainment" rather than "groceries" so I have a better idea of what I'm really spending.

That's it for now. Have a great day!

2 Responses to “Insurance woes”

  1. sagegirl Says:
    1199393720

    MJ- I have worked for physicians officees (billing, scheduling and insurance) for 15 years. Trust me, don't think they are hardballing you so they can stay afloat. They are hardballing you becuase they can and it means $$$ for the shareholders. United Healthcare cut reimbursments to my boss by 10% last year on the procedures he does most. Yet the UHC CEO got a $1.6 BILLION options package in 2006.

    My advice is to keep at them--it takes a lot of patience. But what it comes down to is if they cannot provide you with a local In-Network therapist so you can utilize your benefits the way they want you to, then they need to approve an out of network provider. The thing is the therapist probably makes more seeing you out of network, but he/she might be willing to help you by writing a letter to the carrier and letting them know you still have a need for the services and if he/she would be willing to accept in-network rates.

    Good luck!

  2. Amber Says:
    1199401651

    I did well in regards to dining out myself, by eating breakfast at home and bringing my lunch to work

    also that is great the insurance company is willing to pay some, I say "willing" sarcastically

    I am also sorry about your lost

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