The $101.15 Board Book

Here it is. Does it look that valuable to you??


(Warning: This post is super boring, especially if you're just here for baby pics. But then again, maybe the title piqued your interest. Of course there's a catch, but unfortunately I'm not totally kidding.)

Wanting to switch Abby to a new pediatrician located super close to our house, I called our insurance company to make sure a simple new patient visit for no particular reason would be covered. A nice (but clearly clueless) rep assured me that it would. She also assured me that a charge beyond the usual copay at Abby's last check-up was a mistake and would be corrected.

The visit went well. Any slight preference I may have had for our old pediatrician was wiped out when the new pediatrician gave Abby a board book as we were leaving. Weeks passed. I received a letter indicating a $101.15 charge for the visit to the new pediatrician and reiterating the extra charge for the last visit to the old pediatrician. Prepared to do battle, I called the insurance company again. This time I spoke to a more competent rep with bad news.

Turns out both charges were correct. Because of having so many check-ups in one calendar year, Abby had surpassed a per person annual maximum on preventative care even BEFORE I took her to the new doctor. I repeated the previous rep's answers and explained that I would never taken my child to a new doctor if I had known we were over the limit. The response was simply "I'm sorry but she was wrong." I was livid and stunned at this point. Upon asking how I was supposed to know about this limit, I was informed that it was on the web and in my policy.

Once I realized I had lost the argument, I hung up the phone and cried because I was so mad. When a person calls asking about coverage for preventative care, any decent rep would at least mention the existence of the annual limit, right? Well, as I already knew from my past dealings many of the reps aren't decent. I think they get some of them straight off the street. Then they train them by saying "Never admit that we owe any money ever - make up any reason that sounds good to you." I wanted to call back and try to get the incompetent rep in trouble.

To fully understand my frustration, you need to know a little history about my love-hate relationship with our insurance company. I love the fact that our insurance company paid so much toward our prenatal, maternity, neonatal, and pediatric expenses. I hate the fact that they try to weasel out of paying some legitimate expenses and that they provide terrible customer service. (Let me interrupt this rant to establish that I am so, so thankful to have reasonably good group health insurance coverage.) Here's an outrageous example of how they operate.

Abby was born at a network hospital but the anesthesiologist who administered my epidural (from the only anesthesiology group serving that hospital) was out of network. That tends to put a laboring woman between a rock and a hard place. What are you going to do? Bring your own anesthesiologist? Say "Well, I can't afford the epidural but how about an extra large cup of those free ice chips instead?"? Since I'm nowhere near tough enough for natural childbirth, I sort of considered the epidural "priceless" and figured I'd worry about the financial ramifications later. (Hey, that would make a great Mastercard commercial!) After multiple phone calls, the insurance company acknowledged that my choices were limited and reduced my anesthesia bill by about 40%.

I counted this as a victory and redirected my phone campaign to other bills the insurance company had deemed not covered or duplicate charges. I spoke with many insurance reps. Some were nice, some were mean, some were competent, some were incompetent, but they ALL gave different answers. The last bill was resolved only after eight months! The hospital finally wrote it off after unsuccessfully attempting to reason with the insurance company. Perhaps pride from my success in that endeavor led to my downfall in this situation.

Back to the present. Even though I was furious about receiving bad information from the incompetent rep, I was also ashamed that I was so poorly informed about our coverage. My position on almost every political, social, or educational issue centers around the need for personal responsibility. Maybe I need to listen to my own talking points. Wasn't it my personal responsibility to properly research our benefits before scheduling a very elective doctor visit? That doesn't excuse the insurance company's abysmal customer service but facts are facts. I dried my tears and got out the checkbook.

Now it's time to look on the bright side. We can get a sick appointment with a great pediatrician one mile from our house any time we need to. And we have a fabulous board book, perfectly sized for little hands. At least it's one of Abby's favorites. At that price, it should be!

Just to lighten the mood, I'll close with a picture of my little cutie in her relentless quest to get my camera.