The following is a timeline of my Aetna insurance claim, which began on March 31 and concluded today. What a pain! Guess that’s what I get for trying to make a journey towards better mental health…

If I was actually crazy, I could have had the energy to deal with my insurance company. Here’s my saga, and why you need to advocate for yourself at all times.

My Life Saga (AKA Why I Needed A Shrink)

The last two years in my life have involved two moves, two job changes, the death of my father, and breaking up with the man I loved more than anyone.

It was at the end of 2008 that I really felt like I was starting to lose my marbles. I was absent-minded (beyond being endearing) and I felt like uncontrollably sobbing a lot. I waited for it to get better but it didn’t.

In January of 2009, I start seeing my therapist, appropriately named Bob. Bob and I worked through a lot in about six sessions. Unfortunately the end of our working together was not when things were wrapped up. Oh no my dear friends, the insurance saga was just beginning.

My Insurance Saga (AKA Why Our Insurance System Blows)
The following is a breakdown of how much time and money I’ve spent dealing with my claim of six counseling sessions, a total of six hours, or $660.

March 31, 2009: I mail my claim form to my insurance company. Cost: $.42 Time: 5 minutes

April 2009: I give my month’s notice at my job. I begin shopping for health insurance on my own. I tell Bob I have to stop coming to counseling since I am not sure I can keep affording it.

May 30, 2009: My company health insurance coverage officially ends. Hmph. What ever happened to that claim anyway?

June 2, 2009: I call my insurance company. Hey, did you ever get that insurance claim? I ask. Oh, we never get stuff people mail into us. You have to fax it, the lady tells me. For the record, their website says you can mail or fax. Time: 1/2 hour on the phone

June 4, 2009: Fax sent (claim resent). I know, I’m a sucker. Cost: $2 (since I no longer have a company fax machine to use, I have to go to the fax/copy place down the street), Time: 1/2 hour to gather the paperwork again and go to the fax place.

June 10, 2009: I still haven’t heard from the insurance company. I call the 800 number and everytime I dial, I am told I no longer have coverage and get hung up on my the automated lady. This happens twice.

I call a third time and ask for customer service over and over to the automated system until even the womanly computery voice sounds annoyed. I am connected to a real person.

I hold the poor customer service rep hostage (very nicely though) and refuse to get off the phone until I have the contact name of a real person to send this form to. The woman is super nice, and gets that I don’t want to keep sending information into a black hole of nothingness. I get the name of my contact person, Debra and a direct fax number. I am promised that Debra will call and/or email to confirm she recieved my information.

Also apparently I need a more detailed reciept for the claim to be processed, which I was supposed to magically figure out I guess since no one told me. Time: 1.5 hours

June 10, 2009: I call Bob and he sends me a detailed reciept the next day. Bob assures me I can take my time paying this bill. Thanks Bob! Time: 1/4 hour

June 18, 2009: With new more detailed reciept in hand, I refax. Cost: $8 to fax the forms to Debra at a cost of $1/page (because it is no longer an 800 number) Time: 1/2 hour to go to the fax place

June 18, 2009: Debra calls, she has recieved the form and I should know within a week.

July 20, 2009: I have heard nothing so I call the insurance company. My claim has been processed and the automated system tells me it is covering $393 but I have to pay the amount of $660, which is the full amount. I am confused so I get on the phone with customer service.

There is some confusion, since at work we had switched health plans in April. Somehow the claims have been seperated. Eventually, the customer service rep gets it straightened out and I find out I have to pay the difference between the $660 total and the $390 allowed. Yay, a straight answer! Time: 1/2 hour

Total cost: $10.42, not including cell minutes
Total amount of my time used in dealing with this: 3.25 hours
Total amount received from insurance based on my hounding: $393

Dealing with this claim has made me feel kind of crazy! So was it worth all the effort? Absolutely. Here’s what you can do to save yourself some headaches if you ever have to do this:

1) Find out beforehand what your company will approve. I stayed on the phone twenty minutes with a customer service rep before I even started going to Bob. Don’t feel bad keeping the person on the phone until you are absolutely sure you understand your coverage. It is their job to explain it to you in a way that you understand.

2) Send a certified letter, right off. It costs a little more but someone has to sign for it. Proof of a real person and documentation of when you sent it… and a lot cheaper than my $8 fax!

3) Insist on what you want, nicely. Being a jerk to a customer service person makes you a jerk. They are a cog in the machine and probably are way more like you than the coorporation they work for. Get them to work with you. Oh and when you’re done, say thank you. They probably don’t hear it nearly enough.

3) Keep at it. We could argue that, depending on how much you think my time is worth, that this wasn’t worth the hassle. But to me it was worth saving almost $400 in the end. Don’t let the insurance company wear you down, and if you are not up for the fight, have a friend help. Some people absolutely love this stuff!

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