MORE frustration, billing sucks

Today, I called Theraplay to schedule him for his visits.

They schedule a month out, so slots fill up quickly. Well, when I called I was informed that Aetna does not cover for developmental delay. I informed the person on the phone we had an approval and that Aetna would cover it.

I'm guessing you can figure out that this conversation did not go well, because it really fucking didn't.

She went on to tell me that nothing had changed and I was mistaken. I told her I WAS NOT mistaken and three people in my home heard the conversation I had on Saturday verifying that Aetna did give us an approval even though that we don't have an official diagnosis.

She kept trying to tell me I was mistaken.

I fucking was livid. "I'm sorry you're crying. . ." No shit I'm crying!!! I have been trying for a solid MONTH to try and get my son help that he needs and you assholes are causing major frustration.

I can't afford $850!

"Well, ma'am that's for a block of 10 visits, which your chart says he needs 2 visits a week for 12 weeks."

Yeah, so I'd need over $1700 for THREE MONTHS!

"Well, your copay is $50, why can't you pay $200 a week?"

My head just burst at that comment. How dare she. HOW DARE SHE.

I told her we had half reimbursed through my husbands work and that we could not afford another $200 a week to get my son the help he needs.

She then told me to apply for medical assistance and medicaid. At that point I told her to figure it out and call me back. I was really fucking pissed off.

Of course I posted it on facebook and collected my thoughts. I messaged people I knew in the insurance industry. Then, I called corporate. I got a really nice woman who was LIVID that I was talked to the way I was talked to and she encouraged me to write the president of the company and the VP and let them know what is going on and if they can do anything to help us.

She told me that the location I was working with is saying that the person I talked to on Saturday was new and just calling to book people.

I told her I didn't believe that for a second. Then I told her why. I told her that I verified everything with this woman on Saturday, I told her we didn't have a diagnosis code and she even gave me resources to try and get one sooner.

The conversation ended with me, again, voicing my frustration at this, that I'm doing what they told me to do and if someone made a mistake, it's a pretty fucking big one. I finally have the diagnosis codes and the person in billing told me to call my insurance company and find out if they will approve therapy for him under any of these codes. Then I call my pediatrician and see if they will USE one of those diagnosis codes so my son can get treatment.

Essentially, I need everyone to play ball. I'm not going to hold my breath for it.