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ENT Round 3 Postponed

You may recall from my previous post that I was going to the voice box specialist the following week.  Well, that didn't happen.  Here's the long version.....

The following Monday, I was with my CF doctor at the Medical College while she gave her annual presentation on Cystic Fibrosis.  I was there to give my usual first hand knowledge ;)  As always, I had a great time!!  I love medical students and their eagerness to learn.  As I was driving my doctor back to her office, my phone rang and it was the hospital number.  I ignored and sent to VM.

I said farewell to my doctor and headed back home to finish my daily adventures.  Upon listening to the voicemail, it was the ENT office calling to say that they contacted my insurance and was told that it would be an out-of-network visit.

**Side note:  I get my insurance through my husband's company.  We've have Blue Cross Blue Shield of GA for the last 5-6 years, but due to the 144% increase in insurance costs, they switched to United Healthcare effective 12/1/2016.  Prior to my ENT appointment, I went on UHC's site and verified my coverage and in-network status of the doctor.**

So, I proceeded to call the nice billing specialist and talk about the issue.  She had spoken with the carrier and was told my coverage did not include them in-network.  I then spent nearly 2 hours on the phone with UHC.  They too informed me that it would be an out of network visit.  I had them check my CF doctor (at the same hospital system) and was told she too would be out of network.  And then I was not happy!  The kind CSR checked the ENT I had already been to that month, and he was out of network.  I had her check my dermatologist and gynecologist - all out of network.  WTF?!  How can this be - their website told me it was in-network?  I got disconnected and had to call back - and was told the same thing by another CSR.  However, she said she was not fully trained on the new system and wanted to be sure she was telling me correct info.  She was to go to training on Tuesday and then call me back on Wednesday (the day of my appointment) with any information.  What could I do but agree at this point in the day.

Then, the next day (Tuesday) - I called to postpone my appointment as I wasn't sure what the results would be.  We also got my husband's HR Manager involved which then had me chatting with the insurance broker.  Thank heavens for my HR background and insurance knowledge or I would have been a lost cause.  The broker advised we wait to see if the CSR called back on Wednesday and we would plan from there.  I agreed.

Wednesday - no call back from the CSR.  So by noon, I let the broker know and he would start researching on his end.  I called UHC to see if I could get my contact on the phone, but of course being a big call center that was not possible.  So, I chatted and went through the whole drawn out saga with the new CSR.  Miraculously, she told me that the other CSRs were incorrect.  The claim for my ENT visit last week was processed as in-network.  She verified all my doctors...and they were all IN NETWORK.  Now, I'm stuck between a rock and a hard place.  I've been told 2 totally different versions by the same company! AHHH!!  This lovely lady said the others were not matching my particular plan to the doctor.  She said that the online system was correct because it knew my plan and that I could trust that.  So, she kindly called the ENT office and spoke with the billing specialist to let her know it would be in-network and covered.

Now, I'm going to trust that the final CSR is correct.  I have an appointment scheduled for next week with the ENT and we shall see how that goes!  Fingers crossed!!  Stay tuned for updates on my voice :)


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