Insurance Causes Headaches–(What I’m Sure is Part 1 of a Long Series)

Today I got a call from the hospital I am supposed to deliver at telling me my insurance had denied me permission to deliver there because it’s outside their system.

This was DESPITE the fact that on my reason for filling out a pre-admission form was listed as “Delivery of a fetus with CHD in need of a level 3 NICU”.  Also, DESPITE the fact that my insurance has all of the diagnosis information and referral requests from my doctors.

The hospital admissions called to tell me about it, because my insurance was telling them I was only allowed to deliver at a hospital within their system, one that does not have a NICU that can handle much of anything.  It’s not set up to be a hospital for high risk deliveries.

I couldn’t get ahold of the person from my insurance company who also tried to call me from referrals and I was freaking out.  What if I went into labor today and the hospital wouldn’t admit me?  What if Rowan was born somewhere that couldn’t take care of him because of some stupid piece of paper that wasn’t taken care of or some attempt by an insurance company to not have to pay for something?

I was so upset that I started shaking.  I was worried I’d put myself in early labor freaking about about getting this fixed – which would have just been the worst thing ever.

After thinking about it for a while and calming down, I called my OBGYN’s office and asked to talk to someone who dealt with insurance.  I had no problems with getting referrals from her office in the past and they seemed to have everything working like clockwork with my insurance prior to the whole mix-up today.  I explained what was going on to her and she was amazing.  She calmly told me that they could absolutely not deny me coverage at that hospital and that she had a contact with my insurance company and would call and get it straightened out right away.  She promised it would be fine and she’d call me tomorrow morning when it was all straightened out and that I could go to hospital with the NICU without worry if anything happened.

Lesson Learned!  Call the people who know how to deal with insurance companies and ask for help.  Sometimes you are lucky enough to get it.

Now, several hours later, it occurred to me that if something happens and I need to deliver/go to the hospital…I’m going to the one with the level 3 NICU and my insurance can be dealt with later.  I didn’t need to panic so much today.  I had it in my mind that if I went into labor the hospital I needed would reject me because of my insurance.

My husband wouldn’t have let that happen.  I wouldn’t have let that happen.  My OB wouldn’t have let that happen.

I think I expect to have to fight huge battles with insurance companies and make sure every tiny detail is attended to or something horrible will happen.  I think what I did today, calling the right person to get the situation fixed without me having to do it, is the best way to go.

I feel pretty confident that tomorrow this will all be sorted out and I will have panicked today over nothing.

A blog I read from another family whose child had a heart defect said the number 1 rule with insurance is to keep every piece of paper even remotely related to your pregnancy or your child’s care and to document who you talked to and what date and time anytime a doctor tells you you need a certain service or your insurance tells you it is approved or not approved.

Paperwork is always a headache.  I know I shouldn’t expect this to be any different, but it certainly feels different. Needless to say, I have a very large and rapidly growing file of papers now – with a few more documented phone calls.