Just do your job!

With both of our children having issues that have required extensive medical care this was bound to happen eventually.

Back in December, Peanut had a short stay at Texas Children's Hospital to determine why he had extra fluid surrounding his brain. At the point they decided to admit him, it wasn't that they thought it was an emergency to know what was going on since they had determined his ventricles were okay. Instead the issue was that if they sent us home to follow up, it would be 4-6 months before he would be seen & have an MRI to determine what was going on. It might not have been an immediate need but waiting months to find out wasn't acceptable to any of us. It was at least more urgent than that.

So the point is that someone at the hospital dropped the ball & didn't manage to follow through with getting the pre-cert required for his hospital stay. Oh bloody wonderful! I have been chasing this crap through hoops for months. The hospital says we owe them over $2000 because part of the claim was denied.

Well hellooooooo bone heads! It was denied because someone at your facility didn't bother to make sure the authorization was obtained!!! The insurance company doesn't even show a record of TCH making an attempt for an auth, even though TCH says they started it.

Well TCH, if you did then you could provide me that info so that I can help you get paid! Grrr....

My Plan: I've had enough. I know that we owe them $500 for our co-pay and not a dime over (because the OOP max was met in what, the first few hours of his life? LOL). The insurance co paid for all the medical related services but denied room & board based on lack of authorization. I am willing to file one appeal with the ins co. If it's denied again TCH will be getting a letter along with my payment of $500 explaining that they will NEVER see another dime related to that claim and they can take up the lack of authorization with the employee that failed to do their job or the insurance company but it's not my problem.

If people would just do their jobs, things like this wouldn't happen.