INFURIATED!!!

YES! I AM BEYOND INFURIATED!!!

... If that is at all possible!

 

I will try to only give you the basics but I'm still so mad, I have to write about it to not only make myself feel better -- relinquish the anger -- but hopefully ensure that this doesn't happen to someone else!

 

Back in November ... November 9th, 2012 to be exact ... Jocelyn's shunt failed for the 4th time. You can read the story {HERE}! Well, of course something like this costs A LOT -- no big surprise. However, thankfully because we are military {which comes at a huge price in regards to our family mind you} but that said, we fortunately have pretty good insurance. And don't think for one second that we haven't paid our dues or haven't earned having this insurance!

 

Lots of medical supply companies, industries, hospitals, clinics, etc don't particularly like Tricare because they don't pay the bazillion dollars that they ask for. That's fine ... that's okay! But don't think you can sign a contract accepting Tricare's terms & conditions, and then think you can do whatever you want. YOU as the company, made a conscious decision to be in participation with Tricare! And on a side note, I do think Tricare is pretty fair in what they pay, but they are not going to pay over and beyond just so these places can attempt to recoup what they lose from other people.

 

So with that said, the company called American Medical Response (also know as Medevac Mid-America) has billed us thousands of dollars for transporting Jocelyn from our house to a local hospital. We wouldn't have even used an ambulance, but we couldn't get the seizures to stop. But that's neither here nor there.

 

The hospital we were transported to was not equipped to help us (we already knew that but KS City was a long drive while Jocelyn was unstable) but then, we had to be transported from the hospital to children's mercy which is about an hours drive.

 

Anyways, they have submitted both ambulance trips to our insurance and then accepted Tricare's payment to them. They didn't like what Tricare was willing to pay, so they again sent us bills in January. I called the company and Tricare, had everything resubmitted, etc and thought that was all taken care of.

 

WRONG!

 

Again, we got more bills for several hundred dollars and this is when the fun began today.

 

I ended up calling both American Medical Response (AMR) three times and Tricare three times.

From Tricare - I talked to Sherri, Sherry & Barb

From AMR - I talked to Maria, a girl that made me so mad I forgot to write her name & Ashley

 

***Write names, times & dates -- very important lesson that I learned when I was young and worked for Great Plains Inspection & Butterfly Supply when I first started college! Thank you for the lesson Gary Burke.

 

Come to find out, Tricare wanted AMR to contact them & AMR wanted Tricare to contact them. I found myself as the middle-man.

 

I don't do the middle-man thing.

This is YOUR job -- I'm not getting paid -- YOU figure it out!!!

 

The first lady, Maria, from AMR said it was not their company's responsibility to ensure things got paid and that it was both mine and our insurance. The second lady, who was straight up an idiot, said they filed an appeal to Tricare on 1/18/13 (because Tricare paid too little in their opinion) and have never received a response since that appeal. I asked her "Well who is responsible for doing a follow-up ... perhaps they didn't get the appeal?" She literally told me "Of course they did ... why wouldn't they ... we did our part & I don't know what else you want." This would be where this mama started to get REALLY PISSED OFF!! This second girl refused to transfer me to a manager or anyone else (only further fueling my anger) and we finished the conversation with me telling her that she can go ahead and write in her notes that I'm not going to pay this damn bill because I know my insurance, I know what is covered, I know that I have no responsibility and what they were doing was AGAINST THE LAW and I wouldn't stand for it!!!

 

So in between talking to the 2 ladies from AMR, I talked to the ladies from Tricare. Come to find out, Tricare DID receive the appeal, and paid AMR even MORE money upon re-evaluation!

 

For everyone keeping score -- what was AMR doing? I'll tell you ...

 

It's called "BALANCE BILLING!"

          What does this mean?

                    It means, AMR is trying to recoup even more money from people like me who may not know the difference. I mean afterall, you don't want a bill going to a collection agency right? So you might be aped to pay the bill and then "figure things out later."

 

I could give two shits because I WILL NOT BE TAKEN ADVANTAGE OF!! And I won't be held responsible for a company that is literally breaking the law.

 

This bill they sent has an invoice date of 2/19/13 and you know what I found out through my investigation? After Tricare received the appeal from AMR, they cut a check for a few hundred dollars, thus paying them even more (so their appeal efforts actually did get them more in the end ... great for them!). Anyways, Tricare cut that check on 2/7/13 and it was mailed 2/8/13. AMR ended up CASHING the damn thing on 2/15/13 and then they had the nerve to bill me AGAIN come 2/19/13 just to see if they can get the rest??

 

YOU CAN KISS MY ASS!

 

Once a company decides to accept an "assignment of benefit" then they are required, by law, to write off the remaining balance thus leaving a ZERO balance to the consumer!!

 

It is against the law!

Period!

After talking to the 3rd girl from AMR, Ashley, she told me "Oh yea, after looking through things I see where they did pay more. I will put in here that the responsibility will be taken off the patient for now as its being reviewed by our company. If you don't receive another bill, then great! But if you do, or you are curious, just call back for a status update in about a week."

People -- I'm glad I got through ONE of their thick skulls, but I'm telling you, that last little bit from her? I could've exploded!

So after over an hour of non-stop calling between the two companies, a million questions asked, doing some basic investigation, getting down right ugly about things, holding people by the hand to guide them through a computer and documents like a small child ... what ended up happening?

We currently have no bill -- I think?

And all this will be submitted to Tricare's grievance department because I know for a fact I am not the only one they are trying to pull this bullshit on and I feel bad for all the other family's that have fallen for this.

The Lesson Learned?

Be prepared.

Don't quit after one try.

Don't take no for answer.

Demand explanations.

Stand your ground.

Exercise your knowledge.

Don't allow someone to take advantage of you.

and flipping your "bitch switch" has a place!