"5678!"

No reason for this blog title other than this song puts me in a good mood and its alot of fun. Especially the breakdown at 1:45. Plus Butterfly Boucher is one of the coolest musicians ever and I have met her which makes it extra cool.

It's Friday. Alot going on in my brain. Let's break it down shall we?

I posted on my Facebook page about a statement I got from Anthem in regards to my surgery in November. I look at the statement and essentially it says that they covered everything BUT $5,500.



Below in the explanation of benefits it said "This is not covered by your plan". What is not covered by my plan??? I immediately check my account with University Hospital and I do not see anything for $5,500. But, I felt I need to nip this in the ass. So I called Anthem. After being on hold for 20 minutes, I got someone. She did alot of typing and told me that the "excess skin removal was not covered" and that "UH filed an appeal in December but it was rejected". Floored, I explained this was part of BREAST CANCER RECONSTRUCTION. Lady--do you think I went in there for a nip and tuck?? I explained I had a mastectomy in June. When they do that sometimes they have to leave excess skin to compensate for the expander. Then they can go back in and clean it up. So while he was in there removing the expander he went in and removed some skin. Ironically, I still have to go back in and have more removed because its not settling properly.

She asked me if I wanted to file an appeal. Does a bear shit in the woods? Of course I do! I explained as a part of the Women's Health & Cancer Rights Act they have to cover this. Back in 2008, when I had a mastectomy on the right side, as a part of reconstruction I had a lift on my left side so my boobs matched. ALL COVERED BY UNITED HEALTH CARE(on a different insurance plan as I was married). Why? Because its the law! She took my statement and said it takes around 45 for an answer.

I then emailed my doctor and included the statement from Anthem. He responded within minutes and CC'd the billing supervisor at UH. I have not heard back yet. I will be following up next week. Like I said, I havent NOT received a bill from UH but I am trying to be proactive. I do not need to get into some battle with insurance and a hospital. That should be between them.

I do know this much--IF UH thinks they are getting a dime from me they are sadly mistaken. I will sic Carl Monday on your asses and you dont want him showing up. Trust me:

GET AWAY FROM ME CARL MONDAY!


Happy Friday everyone! Enjoy your weekend!

XOXO
B