CSN Login
Members Online: 1

You are here


ejourneys's picture

I posted this as my Facebook status last night: "Need to call our health insurer first thing tomorrow, given what I picked up at the PO Box today. Good thing I've got my paper trail. My hope is that the issue can be resolved quickly. I'm using my fightin' mojo for kicking cancer's butt, but I am not above multi-tasking if necessary. Wish me luck. (Thanks!)"

The well-wishes and fightin' mojo came pouring in.

Yesterday had been my first day outside since my first Taxol infusion last Thursday and included recycling, mail pickup, bill paying, and grocery shopping. I'm a caregiver as well as a cancer patient, so the bulk of errands still falls to me. Thursday, Friday, and Saturday had been nap days for me, though I had resumed exercising on Friday. I also stayed home because I'm literally toxic for 48 hours after infusion.

My mail included two bills that I shouldn't have received -- one for blood work and one for M's checkup a few weeks ago. I had blown through my deductible and out-of-pocket maximum for the year back in early April, before I had even started chemo. (Cancer does that.) And I had already given M's doctor the co-pay for her checkup.

My PO Box also contained both our statements from our health insurer. (I pay "single" rates for each of us separately, despite the fact that we've been together for 18 years, but that's a whole other discussion.) I opened those envelopes and reviewed the statements while still in the post office.

Good thing I was the only person there, because the language that came from my mouth was not family-friendly.

"Claim denied. Individual not a Covered Person on this date of service."

That line was repeated throughout our statements, with the exception of one claim on M's report that had dated from the end of June. Everything in July had been denied.

The cost of my cancer treatments alone, during my statement's three-week period, had come to more than $9500.

By the time I got home my kick-in-the-solar-plexus shock and naked fear had honed into fury. I grabbed my files and pulled out (a) my bank statement, showing cancelled premium checks covering July; (b) the letters to each of us from our insurer informing us of our annual rise in premiums for the period effective August 1; and (c) our premium notices reflecting that increased cost.

In other words, we were still getting the mail that a "Covered Person" would get. I clipped those documents together with our health insurance statements.

It was Sunday. I would have to wait until Monday before I could start to straighten this out. These days I set my alarm only for medical appointments, but last night I set it for 7:30 a.m. The earliest I could start making my calls was 8.

I spent part of my first half hour awake listening to Snap!'s "The Power" and dancing at my desk. I had no idea whether I was about to get into a drawn-out, bureaucratic fight. I knew I needed to pump up my self-confidence. Health insurers are big business with tremendous lobbying might. I am one individual.

But something interesting happened as I did my battle dance. I realized that compared to the battle I've been waging and continue to wage, this bureaucratic nonsense was just that. I had no reason to be afraid as my inner voice screamed:


My first call this morning was not to our insurer, but to the bank. I knew my premium checks for the period ending July 31 had been processed, but what about the checks for the period beginning on August 1? I had mailed those in on July 9.

Yes, I was told, those checks had been processed on July 15. So far, so good. I asked that a letter to that effect be mailed to me, a.k.a. an "items cleared verification." If I was facing a dispute, I wanted all the paper backing I could get.

It was still too early to call the cancer center and give their financial office a heads-up that there was a problem and that I was on it. But now I could call the insurer.

To my great and pleasant surprise, I got a representative in only about a minute. I know what it's like to be on hold there for two hours -- and then be disconnected.

There was no fight, thank goodness. There was, however, a glitch on their end and a big one. When my policy and M's had entered the new policy year on July 1, the system had dropped us both off the map.

The representative and I were on the phone for more than an hour, going through and fixing every denied claim one at a time and setting up a sweep to catch any further denied claims. The rep's computer was giving her grief, to the point where she had to get off the phone and call me back later, to pick up where we had left off. I left my land line free for her call and used my cell phone to contact every health care provider impacted by the glitch, to let them know that their claims were being reprocessed.

I had made about half the calls when the rep called me back, and we spent another 20 minutes or so hammering everything out. When she asked if there was anything else she could do, I said, "Yes -- I'd like to give you a commendation. What's the best way for me to do that?" She transferred me to her supervisor, where my partner and I both left a message praising her Herculean efforts.

Barring another glitch, all those claims should now go through.

I'm glad and relieved that the issue now seems to be resolved and that I didn't have a dispute on my hands. But I'm also glad that I did as much preparation as I could, in case resolution was long in coming.

I'm especially glad for what I hope is a permanent shift in my perspective with respect to overcoming fear and building my self-confidence. I'm staring down cancer. I'm wrestling with one heck of an adversary. Bureaucratic glitches don't come close to challenging my badassery.

That said, once I was finished with the phone I settled in for a nice, long nap.

Subscribe to Comments for "Fierce"