Kathryn
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Below are the 1 most recent journal entries recorded in the "Kathryn" journal:
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05:51 pm
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Bike Accident Update
Remember Erik's bike accident? Where he was hit by a delivery van? More than a year ago? And how OGI (Other Guy's Insurance) said that they would pay for all current and future treatment?
Well, the bills still aren't paid. They stopped paying the physical therapy bills nine months ago. For 90 days they just didn't return calls at all; after I called to find out what was up, they said that the PIP had been exhausted, and ordered an independent medical exam of Erik to make sure the treatment they'd paid for was medically necessary. (The treatment that had been completed four months prior, mind you.) Erik went along with this farce, because what choice did he have? Skipped a day of work, went to the examiner, got told that yes, it was medically necessary. Then another 90 days of saying that the PIP was still exhausted and that they weren't going to cover the remaining treatment. Finally I got on the horn with Microsoft and asked if we could subrogate to them; they said of course, that all they would need is a Letter of Exhaustion from the insurance company.
90 days of me asking for an exhaust letter go by, with no response. Then, on day 91, suddenly the physical therapist gets a huge fax of all the charges they're denying. Seems the PIP isn't exhausted after all! They just are denying all these charges because they were never documented as to their medical necessity. Except, of course, they WERE documented, our physical therapist documents everything. But now she and her insurance gal have to spend 2 days' worth of lunch breaks going over every denied charge and correlating it to the notes demonstrating its necessity and faxing it back to the insurance company, whom I'm sure will sit on it for another 90 days before coming up with the next bullshit reason why they can't just do their goddamned motherfucking jobs.
Oh, yeah, the current health care situation in this country is AWESOME, let me tell you what.
Tags: bike accident, i hate insurance companies
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