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I know I shouldn't complain too much as I'm lucky to be on a great insurance plan. And for the most part, they are great. But the 3rd party company that they have to do mental health coverage is driving me up the wall. I see a therapist once a month. Twice a year she gives me a receipt for my visits and I mail it in the insurance to get reimbursed. I don't mind this process or taking care of it myself. I'm the one who requested twice a year instead of monthly as well. But dealing with the insurance company always ends up being such a big thing.
I have to specify on my claim that I have in and out of network coverage. Apparently because of how their system is, unless they check the notes, it says I only have in network coverage. I guess I have something called an indemnity plan according to them? No clue specifically what that is, just that it means that I can go to any provider. If I don't remember to put that information on the top of the claim it will get rejected and I have to call in and get them to look at the claim again. And while I don't know how their systems are and what's going on on their end, it's frustrating that I have to tell my insurance company that I'm covered every time. It's gotten so that at least that is fairly simple. Just call and let them know and then wait for them to mail me the check. The first time took about half a year to get everything sorted. Partly my fault because I didn't realize that there was a 3rd party who dealt with it and not my main insurance (which is how it used to be I guess). But by the time it was done it had been about 6 months or so and was made even worse because they didn't want to pay out two of the amounts that were older than a year. Except that those hadn't been older than a year when I sent them in. I had several month left. At least that part is betterish I guess.
I noticed on the check they sent me earlier this week that the copay on the later dates was higher. Not only that but all the copays were higher than the $15 I thought it should be. According to the HR lady I talked to today it should have been $15 for a while and then starting this July, they went to $0. No matter how much the cost, those visits should have no copay at all which is exciting! None of the visits on the recent claim were from after July but they still are all more than they should be. So not only are they not able to figure out that I have out of network coverage when I submit a claim but they apparently can't tell what my copay should be. According to the HR lady we have had all sorts of problems with them not understanding our policy. While we overall go through main insurance provider, our business does not have that providers usual coverage. Usually it's not an issue though. Apparently except for this 3rd party company who apparently we have been having tons of trouble with as far as not paying or not paying the right amount.
On the plus side I get to be reimbursed for the copay overcharge. On the downside I have to call them to get all this sorted. Blegh. I'm trying to look on the bright side I swear!
I have to specify on my claim that I have in and out of network coverage. Apparently because of how their system is, unless they check the notes, it says I only have in network coverage. I guess I have something called an indemnity plan according to them? No clue specifically what that is, just that it means that I can go to any provider. If I don't remember to put that information on the top of the claim it will get rejected and I have to call in and get them to look at the claim again. And while I don't know how their systems are and what's going on on their end, it's frustrating that I have to tell my insurance company that I'm covered every time. It's gotten so that at least that is fairly simple. Just call and let them know and then wait for them to mail me the check. The first time took about half a year to get everything sorted. Partly my fault because I didn't realize that there was a 3rd party who dealt with it and not my main insurance (which is how it used to be I guess). But by the time it was done it had been about 6 months or so and was made even worse because they didn't want to pay out two of the amounts that were older than a year. Except that those hadn't been older than a year when I sent them in. I had several month left. At least that part is betterish I guess.
I noticed on the check they sent me earlier this week that the copay on the later dates was higher. Not only that but all the copays were higher than the $15 I thought it should be. According to the HR lady I talked to today it should have been $15 for a while and then starting this July, they went to $0. No matter how much the cost, those visits should have no copay at all which is exciting! None of the visits on the recent claim were from after July but they still are all more than they should be. So not only are they not able to figure out that I have out of network coverage when I submit a claim but they apparently can't tell what my copay should be. According to the HR lady we have had all sorts of problems with them not understanding our policy. While we overall go through main insurance provider, our business does not have that providers usual coverage. Usually it's not an issue though. Apparently except for this 3rd party company who apparently we have been having tons of trouble with as far as not paying or not paying the right amount.
On the plus side I get to be reimbursed for the copay overcharge. On the downside I have to call them to get all this sorted. Blegh. I'm trying to look on the bright side I swear!
Otherwise I just get myself all sorts of irritated about it. All I can do is call and get things sorted. During the rest of the time when I can't do anything about it but wait, it's best not to put too much stress into it.
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