I hate Insurance Companies (Vent ahead)

Discussion in 'General Parenting' started by StressedM0mma, Feb 9, 2012.

  1. StressedM0mma

    StressedM0mma Active Member

    If any of you work for one I am very sorry. But I am going to scream!! I spoke with difficult child's nurse today, and she said that she is NOWHERE near ready to come home. That she is still hovering between level 1 and FYI (the lowest most restricted level) She is waiting to see how difficult child behaves at visitation this evening. But that she has a ton of work to do to go home.
    So, this afternoon I get a phone call from the Ins. Company. I answer (mistake number 1) I agree that I am Mrs. XXX (mistake number 2). So this woman goes on to tell me that they have reviewed difficult child's case, and that they have decided that she is ready to go home!! I actually laughted at this woman. I told her that I had JUST gotten off the phone with the person that is with my difficult child ALL DAY and she said difficult child IS IN NO WAY ready to leave. And, you the person who has never even met my daughter are telling me that she is fine to leave? She hasn't even been there for 48 hours! Then this woman has the nerve to tell me that it is like a hotel!! A HOTEL!!!! that since they are giving us notice today she would have until discharge tomorrow. Really, my difficult child's stay in a psychiatric hospital is like a hotel? Huh. Not like any hotel I have ever seen.
    So ins.lady tells me that they have a peer review already scheduled, because psychiatric hospital told them she wasn't ready to leave. And then I told her we would be doing the 2 appeals also if we are denied. So she explains to me that we can do the appeals but if we are denied through them all, that we are required to pay from the first day of the denial. Did I say I hate Ins companies?
    I just went off on this lady. I told her that my difficult child would not be safe at home at this point. And, if my difficult child harmed herself it would be their fault. I know not the nicest thing to do/say but seriously. I asked her how someone that has never met my difficult child can make these decisions? That how do they feel they know what is best for her over what her own dr.s and Rns are saying. So fed up. We finally are getting the help she needs and now we are set up with this. I thought we had finally caught a break. husband is going to ask about it tonight when we are there for visitation.

    Please pray that this gets sorted out. We are not bringing her home that is for sure. I just cannot imagine how much this will cost us.
  2. AnnieO

    AnnieO Shooting from the Hip


    This is why Onyxx came home after 3.5 days in psychiatric hospital in 2008...
  3. StressedM0mma

    StressedM0mma Active Member

    I am so F$#*ing mad right now. I think the part that really got me was when she related it to a hotel. I am just sitting here thinking what are we going to do? There is no way we can afford to keep her there on our own.
  4. AnnieO

    AnnieO Shooting from the Hip

    Heck, maybe I should go round the bend and check myself in for a few days. It'd be a nice rest, eh?

    Trust me - right there with ya.
  5. susiestar

    susiestar Roll With It

    I am so sorry. I have always thought that ins co's should be sued for practicing medicine with-o a license. Often the person who is making decisions is NOT well paid or well trained. I temped in an ins co for a while and the people who were going through files and saying that patients were ready to be sent home or taken off therapy or medications or whatever had NO medical training and were paid maybe $10 per hour. It was early 90's, but these people were still dictating medical treatment and most had never been to ANY kind of college, much less graduated medication school. They had checklists and when certain things were checked off, it was discharge time. Regardless of the actual medical problems.
  6. InsaneCdn

    InsaneCdn Well-Known Member

    Ironic smile...

    If this were Canada... once she was at the point of being in the psychiatric hospital and under active treatment... the public insurer pays whatever the doctor orders. HOWEVER... she probably wouldn't be there. There would be a waiting list.


    There is no perfect system out there for ANYTHING medical, and it is way worse for MH stuff. Everywhere.
  7. DaisyFace

    DaisyFace Love me...Love me not


    I do not envy you the battle ahead. Usually these insurance companies DO have some medical personnel at the top - and those folks are actively looking for reasons to deny payment for costly services. Sounds like somebody in that company determined that "crisis services" should be a very brief stay - no more than a "weekend getaway" to refresh and stabilize.

    Will you be able to cover difficult child's care in the interim if insurance co says "DENIED" ? Usually the psychiatric hospital will just discharge at that point unless another source of funding is found...