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Insurance and Doctors and blood, Oh My!

Written on November 15, 2005 by Kevin.

My wife's pregnancy was my first big introduction to the world of doctors, offices, and insurance companies. Yes, I have dealt with them in the past but not for a period of 9 months or so. I am more accustomed to your normal doctor visit here and there. Nothing could have prepared me for what had happened over the past 9 months and just recently as well.

The entire pregnancy began with a couple of blood tests that showed up negative while a week or so later, they showed positive. The problems began then when the office processed her information under an incorrect members ID. Let me explain to you how my insurance company works but first, let me tell you who my insurance company is. I am not afraid to tell you that my insurance company is Cigna. A company that many people have told me are great however I have yet to feel a positive vibe from them. The way Cigna works is that their version of a memberID is simply my SSN with a number attached at the end, such as 01 or 02. Obviously, my ending number is the 01 while my wife's is 02. The problem with the doctor's office is that they processed the claim under my information as if I had my blood drawn for a pregnancy test.

This same type of problem occurred later on with my wife's gynecologist office where they once again, filed the claim under my information. I may be the first man ever to receive a gynecological exam. Yippee for me. Possibly even better than an exam, a few months later, I was billed for an ultrasound. Yes, an ultrasound of my unborn son, that apparently lived in my belly. Once again, I may be the first man that had a baby in his belly. The insurance claim is proof I tell ya.

These issues are not uncommon and happened more than previously mentioned and I see no reason why they will stop. The way Cigna has their memberIDs setup is simply ridiculous. Now with Rylan being born he is simply 03 so for all I know, I may get billed for a circumcision. What does Cigna have to say when I call them up bitching that I'm getting charged for something not physically possible? They simply state, "it appears to have processed incorrectly and we will send it back for reprocessing." In the meanwhile, I have doctor's offices huffing down my back wanting their money.

These issues were all nothing, compared to what happened most recently. Now with my knowledge of Cigna, I made sure then before my wife delivered my son that I would know exactly how much my deductible and whatnot would be. I was told over 3 times that it would simply be $150 per day. A great deal it seems. When the hospital called a month or so prior to delivery, they were telling me it would be $500 + 10% of the bill. Excuse me? So I called Cigna up once again and they again confirmed only $150 per day. My wife and I left the hospital with a whopping $150 bill. Now 4 weeks later I have begun receiving bills saying that I owe in the range of $1000. Back to calling Cigna, and what do they say? "It appears to have processed incorrectly and we will send it back for reprocessing." Well isn't that nice. I now have the hospital wanting their $1000+ while I sit here remembering what the lady told me at the hospital. She basically told me that they are trigger happy about sending people to collections if the insurance company doesn't pay up within 30 days. Well the 30 days is nearly here and all I can do is sit back. What a great insurance company I have. Thank you Cigna, for causing unneeded stress in my life.


Hi Kevin,
I've been reading your blog for a few weeks now. We have sons about the same age! Rylan was high on my name list, but didn't make the cut... Your Ryan is adorable and I have enjoyed reading about him as well as your family's adjustment to life as parents.

My son, Brendan, was born Oct 17th. He is number 6. You can check out my blog if you are interested in my uninteresting ramblings...

I wanted to say about insurance companies... I don't care who you have, how "good" they are supposed to be, blah, blah, blah. Your life is now about to be consumed with EOB's insurance companies hold lines, and rude hospital/doctor's offices staff.

I stay at home with my children and I spend no less than an hour a week on the phone trying to clear problems up. Usually the insurance company has processed something wrong, and we get the same answer of "we will reprocess it". Or better yet, the hospital/lab/doctor doesn't seem to have the insurance info correct, even though we filled out 25 forms, left 25 copies of the insurance card, and even got preapproval because we preregistered. Inevitably, we will get a bill because we "didn't provide the insurance information"... uuuggghhh.

It all works out, but not after lots of phone hold time, which always makes me mad because it takes time away from my precious children.

Don't be afraid to be sent to collections. They can't do anything to you if you have been in touch with the hospitals, etc.

Most important... KEEP NAMES AND DATES of everyone you speak to. My insurance company has recently started handing out reference numbers for each time I call. That says something doesn't it? Lots of people must be calling!! Don't let them take advantage of you. Be firm and document everything.

Hang in there! Parenthood will make you a better man than you ever thought you could be!


Written by Karen on Nov 15, 2005

I agree with Karen.

I've been on several different insurances and they are all the same.

The only additional advice I can give is:
I believe when the hospitals report you to the collections agency that it does hurt your credit.

You might check with your insurance before doing this since you have talked to both the hospital and insurance:

Since you know you'll probably pay something pay the minimum balance or at least some amount towards the bill so you are actually paying on your debt and not appear to be stiffing the hospital (and all of those 'sub companies'/caregivers your family used in the hospital you might not know you used).
OR simply pay the full amount to get them off your back if you can afford to. If you pay more than you are billed for when they finally get their heads out of their butts, your insurance should reimburse the difference. Just like the whole rebilling process the reimbursement will probably take forever.

Maybe you should start a better insurance company yourself and by doing so pay for Rylan's college. Wouldn't that be nice?

Good luck.

Written by Jessica on Nov 16, 2005

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