Because I just can’t keep track of all the different pieces of paperwork, all the authorization letters that contain general language and don’t say what services are actually covered under the number issued, etc., and all the biling entities!
Today I received a Statement of Denial of Payment for $9,000, for my last BIG appointment (CT scan, ECHO, labs, Dr. visit, infusion) on 10/16/12 (aka the post-NZ new cycle visit). Supposedly the referral expired 15 days earlier. Strangely enough, I spoke to the Referrals Office on 11/28, who said a particular Authorization (I say this now, as there are apparently more than one) was extended to that day, but now that I was on the phone, it was extended to Feb. 3, 2013. I’d asked my oncologist to submit reapproval on 11/13, as my prior Authorization letter expired 11/18. So what expired on 9/30/12 that’s causing a $9,000 problem? The Referrals contact (Walnut Creek) mentioned there was a referral approved by the Oakland office. When I mentioned not having received a recent approval, she said she couldn’t do anything about the Oakland referral. But then she placed me on hold, came back, and gave me the new date of Feb 2013. I asked what to do about “the Oakland Referral” to which she said, “Don’t worry about that one.” And I didn’t. I went on my merry way to the 2nd floor of the UC Cancer Center for yet another appointment.
I used to be good at this stuff, but 7 years of cancer has obviously dulled my brain and has definitely made me reluctant to deal with things in a timely manner. So, there’s one referral for travel and the trial, and one just for labs and scans? If that’s the case, and they don’t expire at the same time, then at least some of the charges on the denial should be covered, right? And if I have full Kaiser and full Medicare, why isn’t at least part of it covered? I’m not on a Part C plan, so Kaiser should just pay for the whole thing if Medicare doesn’t want to. I don’t get it.
Now I really do have to call Kaiser Membership Services, Outside Referrals, University of Colorado…everybody. Like, 7 offices, just to straighten this out. It’s ridiculous. The weekend’s been ruined by this… but then, one might say… I should’ve stayed on top of it. To which I could say… I ought to hire a bookkeeper so I can try to let some of this go and live a bit before I go.
I wish I felt better so I could really take care of all this.