Early Morning Insurance Battle

Generally, I don't have a lot of complaints about our insurance. It's a point of service plan that requires stupid referrals but b/c our primary care doctor is very flexible giving them out, it isn't too bothersome. And because I work for the state, it's pretty well priced and 100% coverage outside of the copay. But, I do find it exceedingly annoying that I have to keep getting new referrals for the same doctors we see over and over. So except for one slip up about 2 years ago, I'm very good about getting referrals. I usually call a few days before an upcoming appointment to our insurance to make sure the referral is still good just to be sure that we don't end up having to pay more than we should. So when Caroline and Bryce had an appointment in early October, I called because while I was pretty sure Caroline's was valid, I didn't think Bryce's was. But, the woman I spoke with on the phone, said that it was good through the end of May. That didn't sound right to me so I asked again and she verified that I was fine for my next visit. (This is where having 3 kids and having to remember everything comes into play since I figured I certainly COULD have gotten Bryce a new referral in the spring and not remembered it.)

Then when we got to the allergist for the appointment, I was told by the office staff that they had a fax from my insurance (on their letterhead!) that said our plan didn't require referrals. WHAT? So basically, they saw that his referral was no longer valid, but because they had this fax, they didn't tell me because they figured it was okay. I made sure to get a copy of this fax and contacted the insurance the next day. They seemed totally confused about it and had me fax it back to them which I included a cover letter and asked for some clarification - which I've yet to get. So we had another appointment yesterday and I made sure to get a referral for Piper but was still operating under the assumption that Bryce's referral was valid through May 09.

Then we get home. A statement from the insurance company that says he was NOT covered for his early October visit b/c there was no referral!! WTH??? I was fuming. And then I realized his visit from yesterday wouldn't have been covered either. Soooooo, as soon as I walked in the door this morning I called and navigated through the most annoying voice recognition phone system. At least now I know how to ask for a representative very early on so I can get out of that stupid queue. And as luck would have I got a seemingly competent representative on the phone. Using my most assertive voice, I explained the story to him and told him that when I called in early October I was told that my son's referral was still good because if they had told me it wasn't I would have gotten the referral. I have a history of getting them, so why wouldn't I have done it??? So at this point, I don't know if he was trusting me at my word or he could see in the system that I had indeed called because he told me that he would contact my primary doctor for the referral himself and get it resubmitted along with yesterday's visit. I made sure to get his direct number/contact so I can check in on it next week.

I still haven't gotten any clarification on this mystery fax sent to my allergists, but at this point, it's neither here nor there since I will continue to get referrals no matter what some fax says.

I was cautiously triumphant when I called Jason to tell him and won't feel 100% better until all is said and done. Working in an office that does a lot of paperwork, I know that mistakes happen so I understand that and expect that someone will fix it when it's realized. It's just reconfirmed to me how important it is in these days to stay on top of your records and to be your own advocate because no one is watching out for you but YOU. At least the 2 doctors offices that I have to deal with in this situation are generally flexible and helpful, so that makes it a lot easier.

Flip Flops

I couldn't figure out why Caroline had been insisting on wearing flip flops from last year each day to Cathy's the last few weeks. She didn't like the ones I got her this year that have a strap on the back and only wanted the ones from last year. She has so many cute shoes and 2 really cute pairs of sandals and she only wants those old flip flops. So I always packed an extra pair of shoes in their bag so if they went out to play and run, she'd have them.

But then it dawned on me why she wants to wear them all the time, because I wear flip flops ALL the time now. Since I've been home on maternity leave, about the only shoes I wear are flip flops and of course, she's noticed. I finally figured it out when she asked to wear a ponytail in her hair just like me. Pretty cute - my own little shadow.

Sleep Deprivation = Not So Nice Mama

I feel terrible saying this but I've figured out the less sleep I get (or less restful sleep) the harder my kids have it. I did not get enough sleep on Monday night and then had some running around to do yesterday (I can drive again!) and then I worked online for 2 1/2 hours, so I didn't get a nap in with Piper. When the kids got home, I was exhausted and not very nice. I got dinner and then after dinner, they wanted to watch Milo and Otis, which I turned on for them. But while I was sitting there, I was nursing Piper and anyone that has nursed knows that nursing makes you drowsy to begin with and you add that to already being tired and I could NOT keep my eyes open. And of course, with every scene of the movie, they had 2342532 questions. I'm not sure what Jason was doing at this point but I was so tired of their questions and I was just trying to shut my eyes for a few minutes and they kept asking questions.

Why did the cat do that? Where is the cat going? What is that? Why is that happening??

By about 20 minute in, my answers were not very nice. However, as it got to be after 7pm, I turned the movie off, got together any energy I had and after Jason got their showers, I played with them and read them their books before bed because I felt so bad for being less than nice to them. So the day ended on a good note. However, this morning, while I could still use some more sleep, I am a little more rested and it's just so much easier to manage and be a nice mom again. Truly amazing how that works, isn't it?