Thursday, July 17, 2008

Fighting the Insurance Company Part II

We did it! After weeks of time and hours on the phone, we are being treated "in-network" for our birthing center. This is the biggest weight I've had off of my shoulders in years.

We were quite intent on getting to have our baby in this birthing center. We liked the people we met there and the setting was very comfortable. It's close to us and close to the hospital, in case things get messy. We are nearing the end of the first trimester (so quickly) and we haven't been to the doctor yet.

It was a two-part fight, as a matter of fact. First, we successfully got them to cover the midwife in-network. We thought that was going to be the hard part, since there are actually several nurse-midwives already in-network. Then, I argued our right to not only have the midwife deliver the baby, but to let us deliver it where she practices. Since she doesn't do homebirths, I suppose the insurance company expected us to give birth on the sidewalk.

Today I got news that we are go. I called the insurance company's customer service department to make sure that in-network meant that they would pay for everything. The woman confirmed that all we have to pay is $30 for the first visit.

A wave of peace and relief passed over me like the washing tide on the beach.

At last, there would be no point in me continuing to be a jerk to the insurance company. They did the right thing. They agreed to make concessions so that we can have the birth of our choice, despite several different policies--no matter what I think of those policies. There is no reason for me to continue to harbor animosity toward them. So I told the woman on the phone that if there was indeed a private and/or secret note next to my name that I was some kind of jerk customer, that I understood. But that what they've done for our family is greatly appreciated and treasured by us all; if there was a place to make that note next to my name, I asked her to make it. She denied such a thing existed, but was very happy that I sounded so happy.

I don't know who said that thing about the customer always being right. Anyone who has worked extensively in customer service will tell you that it's total bullshit, anyway. But it's nice to be treated like I know what I'm doing, for once. It's nice to feel like a major company like that can see the reasons I've come to my conclusion and meet me on my side of the fence. I really don't know when the last time when I've fought city hall ways, but I don't think I've ever won.

You watch. Now we'll have twins in that belly of ours and we won't get to be in the birthing center after all. Wouldn't you love a blog about delivering twins unassisted?

6 comments:

jenniferchernoff@msn.com said...

It is too bad we have to fight SO hard for things that seem to be so natural. :/ Congratulations. Hope they don't give you any more trouble!

Wynnie said...

"Now we'll have twins in that belly of ours and we won't get to be in the birthing center after all. Wouldn't you love a blog about delivering twins unassisted?"

I'm pretty sure that comments like this are what spur stories about men killed in their sleep. ;)

Congrats on the win with the insurance company. I wish we had fought harder for ours, but we were lazy.

R said...

"Wouldn't you love a blog about delivering twins unassisted?"

Yes :)

I've read a few unassisted twin birth stories...always wonderful and inspiring. :)

buddzoo said...

I am in a situation where the insurance co. won't even cover midwives/birthing centers as out of network (even though we have out of network coverage). They say, no hospital, no coverage. Any tips/resources on how I can fight them?

buddzoo said...

I am in a situation where the insurance co. won't even cover midwives/birthing centers as out of network (even though we have out of network coverage). They say, no hospital, no coverage. Any tips/resources on how I can fight them?

Sol Smith said...

buddzoo-

I would try and find a midwife and ask her if she's had customers get covered with your insurance company before. That, I would think, might be a first step. Our birthing center knew that our company (Blue Cross) had covered others before.

Look closely at the policy. If you have it. Sometimes the policy says one thing and they say another. They are bound to what the policy says, regardless of what the "customer service" says.

Another thing, you won't get anywhere talking to the customer service team. They aren't authorized to authorize anything. You'll have to go over their heads.

Talk to the referrals team. If your policy covers an OB, ask a midwife for the name of their back-up OB (I think all of them have one) then have that OB give you a referral to the midwife. Push and push that referral department into accepting that referral and approving it.