Okay lets start off with saying, I know I’m a little old to be getting a Tonsillectomy done. Shouldn’t I have done this when I was younger?! Well in all fairness I didn’t start having problems until I was a teenager, I was already in high school, and way to scared to get this done. Also, it was never enforced that it had to be done. I blame my parents. LOL….Okay it’s not their fault….but it’s easier that way.
So tomorrow is my surgery & I’m very nervous. One: I don’t like hospitals. Two: I don’t like needles and I’ll have to get an IV. & Well Three: I have never had any kind of surgery. The most I had done in a hospital was tests for when I broke my wrist.
Friday I went for my follow up with the ENT. The first problem when I walked in was the girl at the front desk trying to tell me that I’m not covered through the Insurance and that I have a 500 deductible that hasn’t been met, so I have to pay $300 now and the rest the day of the surgery plus whatever the hospital may charge. I was shocked & upset. I had purposely called my Insurance Company to make sure what my fees would be so that I would be prepared with the money. When I called they said I was covered and I would only have to pay the $100 co pay at the hospital. So as you can imagine $500 dollars wasn’t on the list of things to pay. So I got on the phone right away with my Insurance Company, they asked to speak to the girl at the front desk, she tells him the doctor is located at Miami Children’s Hospital. She then proceeds to say, Yes that’s what I thought & tells the Insurance Agent to explain it to me. So I get on the phone with the Insurance Agent and he tells me that Miami Children’s hospital is out of network and I have the 500 deductible. Okay understood, except I’m not having the surgery at Miami Children’s, I’m having surgery at Mercy Hospital. I explain this to the Insurance Agent, I said does it go by where the doctors office is located or by where your surgery will be? He puts me on hold to find out more information. As I’m on hold the girl at the front desk is asking another women to help. I confirmed with her that the surgery was going to be in Mercy, just in case I had the wrong information. She said that it was in Mercy, but that I wasn’t covered there either. First of all, how does she know when she wasn’t even the one who called my Insurance Co. The lady who called wasn’t even there. The other women also trying to argue with me. As they are arguing with me, the insurance agent comes back on the phone to tell me that yes I am covered and my only fee is $100. Thank you I said & told him to explain that to the girl. She took the phone and begins to tell the women in front of her in Spanish that she doesn’t understand this and that if she can talk to the insurance agent. The insurance agent then explains the situation and that my co-pay is in fact $100.00. THANK YOU BlueCross BlueShield!!!!! Thank you, INSURANCE AGENT! In your face….receptionist!
I get back on the phone and thank the insurance agent for all his help. I ask the girl at the front desk if I have to pay the regular co-pay for a specialist $30.00. With attitude she tells me no that my fee’s will be paid at the hospital. She proceeds to tell me “You might not even get the surgery, if at the hospital they tell you, your co-pay is $500 deductible you will have to pay it there or you won’t get the surgery”. I said with a calm voice and a smile on my face, “That’s fine, if that’s the case I don’t have a problem with that, but I didn’t want to pay something that I know I’m covered for”. Thank you & I walked away. I proceeded to wait about an Hour after my appointment, the doctor was stuck with a patient that had a problem, but do you think they tell you this. I had to ring the doorbell and ask if the doctor was going to take much longer. She asked for my name again and said you can come in now. I then waited another 5 minutes or so in the room, my patience was running out. Thankfully I really like my doctor and he is truly nice.
Another PROBLEM arises
My medical clearance wasn’t turned into the office. I had to call my primary physician. The girl that handles these cases tells me they left me a message on March 7 & 9th that I needed to get an EKG. I told her I had already called in and told them that I got it the same day I got the chest x-ray. She said then there shouldn’t be a problem but that they didn’t have all the results. Now I have to call today and make sure they have them because I have to pick them up because with out them I can’t get the surgery tomorrow. It’s totally ridiculous. I took these tests with in time so that this wouldn’t happen. So I’m a bit worried that I won’t even have the surgery tomorrow, and as much as I don’t want it, I just want to get it over with. I will keep you updated on if I get to have the surgery or not tomorrow.
The surgery might be at 5:30 or 7 in the morning. I KNOW, Why so early. I am definitely going to be exhausted.
~ “You gain strength, courage, and confidence by every experience in which you really stop to look fear in the face. You must do the thing which you think you cannot do.” ~Eleanor Roosevelt