If you’re like me and have a standard non-HMO plan from a regular health care company you might be in for a surprise when it’s time to settle up. I’ve personally never had any large builds with the doctor but getting married and having babies changed that to the nth degree. You seriously have to be very careful about what you do and how you do it in regards to having a child or you might end up paying out the nose or at least stressing badly while trying not to pay out the nose. Additionally to what you owe they might charge you for what you don’t owe based on clerical mistakes, miscommunication with your health care company and all the general bureaucracy b.s. that comes with it. I’ve actually had a pretty rough go of it so I’ve got some insight that might be helpful to those of you thinking about having a baby.
Here we go, first what not to do:
Do not changing personal information!
My wife was in the process of completing her name change when we were first getting started with being pregnant. We didn’t plan it that way but hey it happened. Now it likely takes months for a medical provider to properly file their claims, get a response and then act on that response. So basically as soon as our baby was born was about the time I started hearing back from the medical provider about claims being denied for name. Through the course I found out if we changed our address or anything else we were likely to be denied. If at all possible you need to either not change anything about your personal information or you need to be very diligent in monitoring your claims processing at the insurance company.
Health providers don’t care(even though they say they do) and they will hound you with debt collection threats on money you don’t owe! I’ve spent upwards to 40 hours dealing with this. I have worked with health care and understand the claims process very well so I feel terrible for the uneducated. I would wager that a large number of people end up paying money they don’t owe because even after decades of experience in the matter health care companies can’t resolve problems. They just dump it on the consumers.
Do not have a baby in a manner that crosses years of coverage!
Get ready to suffer here if you’re on a plan with deductibles. My daughter was born late in the year and it ended up I met my deductibles with around 3 weeks to spare before the year restarted and I owed them again. That’s right. I met our deductible and the year restarted so I could meet it again. Feels like a double dip, acts like a double dip but is not.(sigh)
In addition to this keep in mind that he hospital will charge a number of things to your baby so don’t plan on the stay being attributed totally to your wife’s deductible. Plan wisely when having a baby. I know we don’t always plan this but you really should think about it if you’re even having sex!
Do not change your health insurance at the beginning of the new year!
Unless you’re absolutely prepared. 2 months after having our baby our health insurance policy was scheduled to change. Same provider we were just taking a different option. Well our providers for our baby’s birth had some outstanding things to submit which they did at the very end of the year. They got denied due to a closed policy. I had to spend yet again several hours on the phone with both parties resolving the issue to get them paid.
Seems pretty gloomy doesn’t it? Well it’s irritating and time consuming for someone like me. For the average Joe one of the things above probably can cost them $1000-$3000 in bills they shouldn’t actually owe because they just pay it in order to avoid being bullied by debt collectors. What can you do to mitigate the damage?:
- Verify that you have identical information down to the last apostrophe with both your providers and your health insurance companies.
- Memorize the details of your health insurance policy so you understand how they operate. Realize how deductibles actually work and how they’ll be applied.
- Do not plan on changing insurances the following year or at least be prepared to deal with the fallout.
- Understand that the first line billing department at the hospital probably knows about as much about what you’re calling about as you do. They really are 80%+ just clerical people answering phones with no formal training in health care based on my experience.
- Don’t let them bully you in to paying because the insurance company isn’t paying them timely. Call and chew on your insurance company if you have to.
That’s it for now. I’m writing this article as I’m about to call the hospital’s billing department again even though it’s over 6 months after our baby’s birth and the last conversation they were sure I had settled everything. Realize it doesn’t end at any rational point and you’ll have to fight them to the end.